Operations Oversight Manager - Medicaid Regulations Relevant Educational Qualifications Job5 months ago - Administrative / Management Jobs - Tempe - 128 views
The Medicaid Operations Oversight Manager is responsible for ensuring that Medicaid compliance requirements are correctly implemented by impacted operational teams to ensure regulatory compliance. This leader serves as a liaison to and works in collaboration with the CareCentrix Compliance Department and operational areas on all Medicaid program issues and risks.
In this role you will:
- Research and understand compliance requirements in developing Medicaid markets
- Establish departmental policies, practices, and procedures to embed processes that comply with applicable Medicaid requirements in impacted CareCentrix operations
- Serve as a liaison between the Medicaid team and internal operations leaders and the Compliance Department
- Ensure proper understanding and implementation of Medicaid compliance requirements in impacted operational areas
- Follow-up with appropriate operational areas to ensure required changes to comply with Medicaid requirements are effectively implemented
- Identify and oversee implementation of risk mitigation strategies
- Ensure direct line leadership and the Compliance Officer are informed of all material compliance concerns, operational issues and associated corrective actions/remediation impacting Medicaid operations.
- Accountable for status reporting to Medicaid leadership and the Compliance Department.
- Identify and address Medicaid compliance risks and manage action plans designed to fully mitigate Medicaid compliance risk(s).
You should reach out if:
- You have a Bachelor's degree in business or related field
- You have a minimum of five (5) years of healthcare payer experience including three (3) years in Government Program products
- You have demonstrated understanding of Compliance and Regulatory fundamentals specifically related to managed care and government programs (CMS/HHS/DOI/Medicaid)
- You have the ability to foster teamwork and build collaborative relationships.
CareCentrix maintains a drug-free workplace.
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.