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Project Consultant
Location: US-MI-Southfield
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TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc. Title: Project Consultant Work Location: Southfield, MI 48075 Dept: SVP-SHS Operations BC -
Program Oversight Project Consultants are responsible for leading processes and projects that ensure compliance oversight and ongoing monitoring of Client Medicare Advantage and Part D programs. -
This position's responsibilities include assessing regulatory guidance and processes to ensure compliance with CMS regulations for Medicare Advantage operations. -
This role develops and improves workflows and business processes to strengthen controls, mitigate risks, and improve quality and efficiency. -
Interface with internal customers and vendors to identify and/or analyze business problems and develop solutions is required. -
Develop and implement risk assessment and monitoring review processes to mitigate and/or remediate risk within the Medicare Advantage (MA) line of business -
Identify, analyze, and develop solutions to assist in the identification and mitigation of compliance risks and strengthen controls -
Track and manage corrective action plans to address identified compliance risks and deficiencies. -
Draft communications for executive leadership, and internal departments -
Research, interpret, and understand CMS regulations and applicable laws -
Conduct mapping of requirements to ensure compliance -
Participate in focused project workgroups -
Interface with various departments, senior management, and individuals to provide expertise in compliance and regulatory issues and initiatives -
Represent leadership staff at meetings in their absence. -
TekWissen Group
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