Director, Compliance Administration
Long Beach, CA
Our mission is simple: Keeping Seniors Healthy and Independent–that’s been our mission for almost 40 years. Rated as one of the top Medicare Advantage plans in California, SCAN Health Plan employees are passionate about what they do. Understanding that success is based on achieving the mission, SCAN employees are afforded with the training and tools necessary to do their jobs and they are rewarded for their efforts and recognized as experts in their fields. Ask anyone who works here and we’ll proudly tell you that SCAN’s commitment has never wavered. We are as steadfast in our pledge to help our members live healthy and independent lives.
Direct plan efforts and initiatives to achieve and maintain compliance with Federal and state regulatory requirements and contract standards. Lead a team responsible for compliance-related activities that include but are not limited to overseeing the plan’s policies; timely submitting of regulatory filings; and coordinating audits of the plan.
Serve as the plan-lead in managing regulatory audits and monitoring reviews of SCAN by federal, state, and local regulators and agencies. This includes maintaining a review process for all plan audits and monitoring review deliverables prior to submission to help ensure that they are accurate, complete, and timely.
Track and monitor completion of corrective action plans (CAPs) to remediated deficiencies, and process improvements to address observations, identified external audits and monitoring reviews.
Ensure compliance with federal, state, and local regulators and agencies by establishing processes that ensure timely and complete reporting submissions of required deliverables.
Manage regulatory interactions and filings with federal and state regulatory agencies.
Provide administrative support for Regulatory Affairs team through tracking and monitoring regulator deliverables, and facilitating communication between Compliance and business units to collect required responses and documents.
Ensure CMS HPMS memos, DHCS All Plan Letters, and other governing regulatory policy documents are analyzed to identify implications for the plan; distributed throughout the plan to accountable staff; tracked to confirm completion of required new plan actions; and that new required submissions by the plan are logged for monitoring by Compliance.
Ensure SCAN’s insurance policies remain up to date and renewed as needed.
Serve as the liaison with the plan’s insurance broker and track, and ensure timely completion of required actions to maintain the plan’s insurance policies.
Investigate and resolve reporting potential compliance issues and/or allegations of non-compliance.
8 years’ experience in compliance
8 years’ leadership/management experience
5 years’ experience in managed health care
3 years’ experience managing resources of a business unit, including financial budgets and maintaining business planning strategies.
Proven ability to exercise independent thought and decision-making skills.
Ability to work effectively and participate in a team environment.
Ability to challenge regulators, peers and superiors when necessary while maintaining respect and professionalism.
Your preferred qualifications
What's in it for you? Qualified employees will receive
A competitive compensation and benefits program
An annual employee bonus program
Generous paid-time-off (PTO)
Ten paid holidays per year
Excellent 403(b) Saving Plan, providing up to 4% match and vesting after three years
A work-life balance and much more!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
SCAN is an Equal Opportunity Employer: Minority/female/disability/veteran.
It is our policy to abide by all federal, state and local laws prohibiting employment discrimination and all qualified applicants will receive consideration for employment. SCAN will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Please view Equal Employment Opportunity Posters provided by OFCCP here
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Website : http://www.scan.co.mz/en/
SCAN is a first-tier law firm in the Mozambican Market. Created in May 2009, as a result of the association of a highly reputable and experienced team of lawyers, with around 14 years of experience in strategic areas of law in Mozambique, SCAN provides efficient and dynamic client-oriented solutions.