Compliance Officer, Arizona
Core
Oversee all compliance functions for a health plan, including policy development, CMS Medicare SNP requirements, and state regulatory interactions.
Role type
Senior Compliance Officer (Health Plan)
Builds
Compliance programs and audit processes for health plan operations
Domain
Healthcare / Insurance / Regulatory Compliance
Required skills
Compliance program management, State Medicaid program experience, Internal and State audit management, Health care regulatory agency relations, Contract requirements implementation, Enterprise Risk Management, Corrective action planning, Subcontractor oversight
Preferred skills
Master's Degree in related field, 10+ years in Compliance/Enterprise Risk Management
Technologies
CMS systems, State regulatory platforms, Audit management tools
Responsibilities
Oversee accurate and timely submission of CMS Medicare SNP requirements; Serve as senior leadership and single point of contact in State compliance meetings; Manage daily interaction with state regulators; Lead Department of Insurance and HHSC audit processes; Conduct internal compliance audits and write corrective action plans; Manage oversight of compliance for health plan material subcontractors; Represent senior management at state committees and seminars.
Seniority
Senior, hands-on IC