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Manager Compliance

Location
Raleigh, North Carolina
Job Type
Permanent
Posted
22 Jul 2021

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at .

Responsibilities:

The Manager, Compliance provides support in the development and implementation of the compliance program for AmeriHealth Caritas North Carolina (ACNC)   and the implementation of compliance policy, process and control activities. The Manager is responsible for the oversight of the ACNC  Agreement to ensure compliance with contractual requirements.  This position will also monitor the execution of operational changes required by regulations and guidelines and possess the following attributes: 

  • Conducts audits of internal business units and processes to assess contractual compliance.  Identifies gaps, weaknesses and deficiencies.
  • Initiates or supports corrective action plans identified through audits, monitoring, departmental performance indicators.  Follows through on all corrective actions until standards are met.
  • Assists in the identification of gaps, weaknesses and deficiencies and/or business productivity/efficiency opportunities.
  • Ensures that local compliance related issues and risks are reported.
  • Assists in the development of compliance methodologies and monitors the effectiveness of compliance related processes.
  • Implements and monitors metrics and ensures accurate reporting of compliance information.
  • Assists in regulatory and/or contractually-based research projects and is able to present findings in a clear and concise manner.
  • Completes other duties, as assigned. 

The Manager, Compliance must be able to operate independently with minimal management oversight and be able to manage competing priorities and deadlines that are subject to frequent change. Must possess and exercise excellent professional judgment in all interactions.

Education/ Experience:

  • Bachelor's Degree.
  • 3 to 5 years in a managed health care environment, including experience in the areas of compliance oversight preferably in LTC.

 

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Details

  • Job Reference: 333952768-2
  • Date Posted: 22 July 2021
  • Recruiter: AmeriHealth
  • Location: Raleigh, North Carolina
  • Salary: On Application
  • Sector: Manufacturing Operations
  • Job Type: Permanent