Requisition ID: 97101
There's more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we're reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what's best, not more of the same. And if what's best hasn't been done yet, it's our exceptional and passionate employees driving this change. But, our passion for vision isn't just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world's vision crisis.
Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, Target Optical and Sears Optical.
If you're passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America's fastest growing vision benefits company.
The Manager- Compliance (Programs) is responsible for monitoring and driving compliance oversight for the organization and any downstream entitys/vendors. This includes operational processes and programs to ensure compliance with Medicare Advantage (MA) regulatory requirements. The Manager leads all monitoring initiatives within the company and is charged with incorporating innovative means to utilize contractual client audit requirements. The Manager collaborates with the compliance team and the compliance business partners to develop, implement, and maintain ongoing monitoring processes. The Manager is also responsible for reporting and communication of monitoring results. This Manager also collaborates with business owners and/or delegated vendors to drive remediation as necessary and to assist EyeMed and its downstream entities through oversight and monitoring and in meeting its MA Clients program requirements.
MAJOR DUTIES AND RESPONSIBILITIES
Effectively leads internal monitoring processes for EyeMed, including incorporation of ongoing client audits as an internal monitoring tool.
Receives and reviews self-monitoring results from the key operational areas and downstream entities to ensure compliance with regulatory requirements.
Evaluates the effectiveness of downstream entity compliance programs and related policies and procedures.
Identifies and communicates trends and outliers from monitoring and oversight results.
Prepares accurate and timely formal written reports on oversight and monitoring activity findings and recommendations and properly prepare supporting work papers, including sufficient evidentiary material exists to support oversight and monitoring activity findings.
Assists in the assessment of new and amended MA Client contracts and requirements for monitoring purposes.
Collaborates with other departments and/or delegated subcontractors to direct compliance issues to appropriate channels for research and resolution.
Reviews and evaluate the status and effectiveness of corrective action plans and provide comprehensive follow up to the Compliance Officer, Senior Management and key stakeholders.
Bachelor's Degree in a related field
5+ years of compliance monitoring and oversight experience
2+ years of experience in project oversight role with demonstrated ability to drive implementation and influence others
Understanding of the regulatory framework within which the company operates
Analytical approach to process review and results
Demonstrated project management skills and to drive multiple projects
Collaborative workstyle with the ability to build partnerships, teamwork and good working relationships
Ability to influence internal and external constituents
Demonstrated ability to deal with confidential information
Ability to effectively present information and respond to questions from peers and management
Ability to work in a fast paced environment with changing priorities
Experience with Microsoft Office Products (Outlook, Word, PowerPoint, Excel, Access)
Experience in the Medicare Advantage Compliance industry (i.e. Plan, vendor, consulting)
Proven experience in performing effective monitoring and oversight within an MA organization
Regulatory or legal training / experience
Knowledge of CMS regulations
Certification in Healthcare Compliance (HCCA) preferred
Intermediate-level experience with Microsoft Project
Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please contact Talent Luxottica at 877-589-8253 (513-765-2256 outside of US) or email TalentLuxottica@luxotticaretail.com
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, religion, age, disability, sexual orientation, gender identity or expression, citizenship, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law.
The Luxottica Group