Compliance Manager

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Unless specifically stated otherwise, this role is "On-Site" at the location detailed in the job post.This position is available for remote/WFH within Louisiana, candidates must reside in Louisiana.Serves as the compliance and privacy manager for assigned areas of the company or an SBU as applicable. Assists with regulatory and contract compliance for business managed by the Care Center or supported by corporate compliance. Responsible for the implementation of or support of the SBU and/or Corporate Compliance Program, Health Insurance Portability and Accountability Act (HIPAA) compliance, including audits and the preparation for state and customer audits.If applicable, oversees the implementation and ongoing operation of the Compliance Program for the assigned SBU(s).If applicable, develops and annually updates a formal written compliance program for the assigned Care Management Center and educates staff about compliance and the appropriate details of the compliance program.Directs federal and state regulatory and compliance activities.Customizes corporate policies where necessary to address state regulatory standards and/or contractual requirements and, where applicable and works with corporate compliance on any customizations that are required due to state regulatory standards.Serves as a liaison for customers on legal and regulatory issues.If applicable, chairs the local compliance committee meetings.Coordinates activities with the Internal Audit and Special Investigations Unit (SIU) on compliance matters including fraud, waste, and abuse auditing and monitoring, as directed.Ensures corrective actions are implemented for all known compliance deficiencies. Submits reports to the Quality Improvement Committee (QIC), Compliance Committee, Business Unit Manager, and the corporate Compliance Department as appropriate.Maintains expertise related to authorization and non-authorization correspondence requirements from the perspective of the Employee Retirement Income Security Act of 1974 (ERISA), National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), federal regulations and state law.Assists in review of standard correspondence, notifying policy content experts of changes to standard policies, and working with IT regarding system changes as it relates to correspondence.If applicable, attends customer meetings to report on compliance matters.Serves as central contact for internal and external customers regarding certain parts of the corporate compliance program as assigned or, where applicable, security, HIPAA, and anti-fraud efforts within the assigned Care Center.Assists with internal and external audits and reporting, including periodic reports documenting compliance status..If applicable, oversees Care Center-delegated entities and their compliance activities and assure that compliance data from the delegated entities are reported to the Quality Improvement Committee (QIC).The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.