Current Openings at ALC Staffing Associates

Sr. VP-Compliance-Healthcare
$180K - $200K / Year
Minimum Education:
Job Type:
Full Time
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Sr. VP-Compliance-Healthcare
*Senior level compliance background.
*10+ years of compliance program management and contract experience.
*Vice-President or above.
*Not looking for a Director to make a step up.
Milwaukee, WI
Salary: $180K-$200K + 20% Bonus
Nationwide Relocation Assistance Available

Position Purpose:
Ensure regulatory compliance with state and other government agencies related to the health insurance industry, the organization, and its business subsidiaries.

Job Description:
Develop and implement strategic vision for compliance and ethics culture within the business unit ensuring alignment with Corporate.
Ensure business unit is in compliance with state and federal program regulations, insurance regulations, regulatory requirements for business entities and state contract requirements.
Develop policies, procedures, and processes to ensure compliance with state law, federal law, contract requirements, and various standards.
Oversee compliance integration and support of business operations and support units.
Oversee, administer, and implement various compliance programs, including fraud and abuse and HIPAA.
Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements related to regulatory and contract language.
Develop strategic relationships with state and federal regulators and assist with the development of internal and external policies concerning state insurance, Managed Care Organization, Medicare and Medicaid regulations and initiatives.
Identify, evaluate and analyze the impact of state and federal, regulation, policy and contract requirements and resulting issues.
Develop positions, alternatives, recommendations and advise management concerning impact.
Oversee fraud and abuse programs on the health plan level, collaborating with the special investigation unit team and serving as main regulatory liaison.
Oversee development or adoption of Corporate’s special investigation, ethics and compliance training to include delivery, monitoring and reporting
Conduct compliance monitoring.
Develop and implement performance improvement plans, corrective action plans, and report on achievement of action plans to senior management.
Oversee the maintenance and tracking of laws and regulations, contract documentations, amendments, and various compliance measures and ensure appropriates are taken to address changes.

*Bachelor's degree in Public Policy, Government Affairs, Business Administration or related field.
*10+ years of compliance program management and contract experience.
*Extensive knowledge of state administrative code and regulations, state insurance laws and regulations including managed care regulations.
*Experience with state and federal government agencies, accreditation bodies, participating provider agreements, HIPAA and Third Party Administration (TPA) laws, credentialing regulations and prompt pay laws.
*Master’s or Law degree preferred.
*15+ years of program management and contract experience preferred.

Equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Arthur L Crume
ALC Staffing Associates
509 N Vermilion
Ste. 540
Danville, IL 61832
Fax: 888-315-4340
Phone: 217-636-3930

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