Medicare Compliance Manager

Florham Park, NJ, United States

We are...

We are a global collective of innovators applying the New every day to improve the way the world works and lives. New doesn't mean being ahead of the curve; new is pushing forward the curve, riding the edge where the impossible meets the transformational and making it reality where it matters. Help us show the world what's possible as you partner with clients to unlock hidden value and deliver innovative solutions. Empowered with innovative tools, continuous learning and a global community of diverse talent and perspectives, we drive success in a new business architecture that disrupts conventional practices. Our expertise spans 40+ industries across 120+ countries and impacts millions of lives every day. We turn ideas into reality.

You are...

As a member of Accenture's healthcare team, you'll be part of a team of health advisory professionals. From rapid deployments to entire transformations, you'll deliver leading edge Medicare strategy and operations capabilities to our clients.

As a Medicare Operations Compliance Manager , your primary responsibilities may include:

Compliance Program Development:

Create, maintain, and enhance the compliance program for Medicare Advantage Plans, including the development of policies, procedures, and controls.

Develop a compliance roadmap that aligns with regulatory requirements and business objectives.

Regulatory Analysis:

Stay up-to-date with changes in Medicare Advantage regulations and industry standards.

Conduct regulatory assessments and provide guidance on compliance implications.

Auditing and Monitoring:

Establish a robust auditing and monitoring program to assess compliance with regulatory requirements.

Conduct regular internal audits and risk assessments.

Compliance Training:

Develop and deliver compliance training programs for employees and stakeholders within the Medicare Advantage Plan division.

Promote a culture of compliance awareness and accountability.

Reporting and Documentation:

Prepare and submit required compliance reports to regulatory authorities as necessary.

Maintain comprehensive records and documentation of compliance activities.

Issue Resolution:

Investigate compliance issues, violations, and complaints.

Develop and implement corrective action plans and monitor their effectiveness.

Cross-functional Collaboration:

Collaborate with cross-functional teams, including legal, operations, and quality assurance, to ensure alignment on compliance initiatives.

Serve as a subject matter expert on compliance matters.

Why should I join the Accenture Health team? Innovate every day. Be at the forefront of designing and delivering Medicare and other health technology solutions that push boundaries and create new opportunities for our clients.

Lead with the industry's best . Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members.

Learn and grow continuously. Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life client simulations and ongoing mentoring available when you need it, you'll expand your thinking beyond the core Workday implementation.

Who will be successful at Accenture?

It's not just what you know or where you've been that propels success at Accenture: It's who you are, fundamentally, as a person. We prize diversity in backgrounds and perspectives. Whatever your unique qualities, a few key traits should apply: You're passionate about technology and motivated to apply the latest technology trends. You're proactive and collaborative; a leader with effective communication skills. You're driven by new challenges and are motivated to improve. You're a creative problem solver with the flexibility to navigate uncertainty. You're focused on the future with a desire to develop inclusive, responsible and sustainable solutions to complex challenges.

Travel may be required for this role. The amount of travel will vary from 0 to 100% depending on business need and client requirements.

Here's what you need: Bachelor's degree in healthcare administration, business, law, or a related field; Master's degree or relevant certifications preferred or 12+ years equivalent working experience.

Minimum of 5 years of experience in healthcare compliance, with a focus on Medicare Advantage Plans.

Minimum of 5 years of experience with strong understanding of Medicare Advantage regulations and compliance requirements.

Bonus points if: Experience working with or leading global teams.

Thrive in a diverse, fast paced environment.

An advanced degree in the area of specialization

Excellent knowledge of compliance best practices and methodologies.

Executed or led a Medicare Advantage operations compliance audit.

Exceptional analytical, problem-solving, and organizational skills.

Strong communication and presentation abilities.

Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, New York or Washington as set forth below.

We accept applications on an on-going basis and there is no fixed deadline to apply.

Information on benefits is here.

Role Location Annual Salary Range

California $93,400 to $258,500

Colorado $93,400 to $223,300

New York $86,500 to $258,500

Washington $99,500 to $237,800

What We Believe

We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.

Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities. Read more here

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