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Regional Compliance Manager in Grand Rapids, MI at Beacon Health Options

Date Posted: 2/16/2019

Job Snapshot

Job Description

About The Position:

The Beacon Health Options Regional Compliance Manager will work closely with the AVP of Corporate Compliance on processes and systems to monitor Medicaid Managed Care (Medicaid and Medicare-Medicaid Plans), for corporate and governmental requirements. This individual will analyze business requirements, provide research and regulatory guidance, and advise internal business units to ensure full compliance and minimize risk. The Regional Compliance Manager tracks federal and state of Michigan regulations and Centers for Medicare and Medicaid Services (CMS) guidance that might affect the organization's policies and procedures and works with members of the compliance team and operational areas to design policies and training as appropriate. The Regional Compliance Manager will be a compliance subject matter resource to functional departments and a member of the enterprise-wide compliance team. The Regional Compliance Manager serves as the lead for monitoring of compliance activities and effectiveness for Michigan

Position Responsibilities:

  • Maintain current knowledge of applicable federal and state laws including up-to-date knowledge of developments in Michigan and federal Medicaid and privacy rules, and with legislative and regulatory implications for the Behavioral Health and Wellness industry, and the Beacon Health Options services.
  • Initiate, facilitate and promote activities and communications that foster local compliance awareness, knowledge, and effectiveness.
  • Work with the Compliance Training Manager to develop and implement general compliance and privacy training on local policies and procedures. Conduct and document trainings.
  • Work with operational leadership to provide adequate information to ensure that they and their staff have the requisite information and knowledge of regulatory requirements to carry out their responsibilities in a lawful and ethical manner
  • Assist account/operational management in responding to client and CMS audits of the compliance functions and provide technical assistance to improve performance  
  • Participate in the development and implementation of ongoing compliance monitoring and risk assessment for assigned location.
  • Participate in the annual review and update of national policies and procedures related to access to General Compliance, Medicaid and the disclosure of Protected Health Information PHI).
  • Participate on strategic project teams, local management and compliance meetings, special initiatives, and performs other duties as assigned.

Position Requirements:

  • Education: Bachelor’s degree in a healthcare, communications, business management or related field.  Preference will be given to candidates with certifications related to their professional training, such as, Certified in Healthcare Compliance (CHC)®, or Certified Compliance & Ethics Professional (CCEP)®.
  • Relevant Work Experience: Minimum of four years of experience in Michigan Medicaid healthcare compliance.  Managed care experience preferred.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled