Compliance Officer

• Oversee all compliance functions for the Illinois health plan including communication and coordination of policy development
• Oversee the accurate and timely submission of over-contact deliverables for all lines of business and service delivery areas
• Oversee the accurate and timely submission of all CMS Medicare SNP requirements
• Serve as senior leadership and single point of contact in all State compliance meetings and interactions
• Manage direct correspondence and daily interaction with all state regulators
• Serve as senior leadership in all Department of Insurance and HHSC audit processes
• Managing all facets of the audit and communications
• Serve as senior leadership in Enterprise Risk Management process
• Conduct internal compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with federal, state and local regulatory requirements
• Accountable for the management and oversight of compliance for all health plan material subcontractors to include directing the performance of annual oversight

Requirements

• Bachelor’s degree in related field
• Master's degree preferred
• 7+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits
• 5-7 years of experience with health care regulatory agencies in development of compliance and fraud programs
• 5+ years experience with overseeing implementation of contract requirements

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Hard Skills

• compliance program management
• contract management
• internal audits
• corrective action plans
• regulatory compliance
• fraud program development
• oversight of contract requirements
• audit processes
• Enterprise Risk Management
• policy development

Soft Skills

• leadership
• communication
• coordination
• interpersonal skills
• organizational skills

Certifications & Qualifications

• Bachelor's degree
• Master's degree