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Compliance Manager - Investigations - Health Alliance Plan - Troy

Company: Henry Ford Health System
Location: Troy
Posted on: March 25, 2020

Job Description:

GENERAL SUMMARY:Plan, lead and manage the day-to-day operation of the Compliance Program, regulatory audit, FDR oversight, and risk assessment for all HAP and HAP subsidiary lines of business. Responsible, under the direction of the Director-Compliance, to provide overall strategic direction to manage compliance. Develop and implement compliance processes, compliance risk assessments and assist in the development of compliance education. Act as a liaison for the Compliance department, collaborating with key departments and Compliance Leads to ensure policies and procedures are designed, developed, and implemented to ensure compliance and collaborate with cross-functional teams to develop, enhance and implement departmental compliance programs to promote continued awareness and adherence to compliance. Manage audit activities related to compliance issues and violations including coordinating with business units and departments to monitor and assess violations, ensure timely investigations and corrective actions as well as tracking of violations for the purpose of annual reporting.PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Develop and implement annual compliance work plans, risk assessments and other compliance program materials that reflect and address mitigation requirements for compliance program risks. Assist in development of policies and procedures in accordance with compliance rules and regulations.
  • Disseminate written policies and procedures related to compliance activities.
  • Manage regulatory audit program to ensure compliance procedures are followed.
  • Lead, plan, develop and conduct education and training activities related to compliance activities and topics.
  • Develop presentations and educational materials for departments and individuals at all levels to provide education and compliance regulatory updates.
  • Represent Director-Compliance when necessary to facilitate compliance committees.
  • Implement monitoring and reporting process regarding all ongoing compliance activities under the direction of the Director-Compliance.
  • Oversee the analysis and investigation of compliance violations.
  • Conduct routine audits of the compliance program.
  • Perform other duties as assigned.EDUCATION/EXPERIENCE REQUIRED:
    • Bachelors degree in health careadministration, public health, business, or related field. Master's preferred.
    • Minimumof five (5) years experience in insurance industry which includes:
    • Experience in healthcare compliance
    • Experience with Affordable Care Act, Medicare Advantage, Part D,and Medicaid compliance regulations
    • Working knowledge of corporate compliance policies/procedures
    • Two (2) yearsexperience in a managerial/supervisory position and with leading staff inprojects within a health care environment preferred.
    • Certificationor designation in health care or managed care a plusOverviewUnder the leadership of President and CEO Wright L. Lassiter, III, Henry Ford Health System is a$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sitesincluding medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities andother healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health systemnow has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, oneof the nations oldest physician groups. An additional 2,200 physicians are also affiliated with thehealth system through the Henry Ford Physician Network. Henry Ford is also one of the regions major academic medical centers, receiving between $90-$100 million in annual research funding andremaining Michigans fourth largest NIH-funded institution. Also an active participant in medicaleducation and training, the health system has trained nearly 40% of physicians currently practicingin the state and also provides education and training for other health professionals including nurses,pharmacists, radiology and respiratory technicians. visitHenryFord.com.BenefitsWhether it's offering a new medical option, helping you make healthier lifestyle choices ormaking the employee enrollment selection experience easier, it's all about choice. HenryFord Health System has a new approach for its employee benefits program - My ChoiceRewards. My Choice Rewards is a program as diverse as the people it serves. There aredozens of options for all of our employees including compensation, benefits, work/life balanceand learning - options that enhance your career and add value to your personal life. As anemployee you are provided access to Retirement Programs, an Employee Assistance Program(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits. Equal Employment Opportunity/Affirmative Action EmployerEqual Employment Opportunity / Affirmative Action Employer Henry Ford Health System iscommitted to the hiring, advancement and fair treatment of all individuals without regard torace, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,weight, marital status, family status, gender identity, sexual orientation, and genetic information,or any other protected status in accordance with applicable federal and state laws.

Keywords: Henry Ford Health System, Troy , Compliance Manager - Investigations - Health Alliance Plan - Troy, Executive , Troy, Michigan

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