The Senior Compliance (UM) Professional conducts and summarizes compliance audits. The Senior Compliance (UM) Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Compliance (UM) Professional collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Ensures mandatory reporting completed. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
5+ years of technical experience
5+ years experience with accrediting compliance for medicare advantage programs.
Medicare, Medicaid, and/or legislative/regulatory experience
Experience in Project Management
Excellent oral and written communication skills
PMP or Six Sigma Certification
Comprehensive knowledge of Microsoft Word, Excel and PowerPoint
Scheduled Weekly Hours