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Indiana University Health

Compliance Manager - Health Plans

IU Health Plans
Date Posted
07 June, 2021
Schedule & Shift
Full Time
Day
Requisition Number
309029
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Compliance Manager - Health Plans

Job Description

Overview

Implements the strategic compliance program plan into Health Plans-wide operations. Provides transformational leadership and direction to develop, recommend, and implement compliance program activities, policies, procedures, and standards in accordance with Federal and State laws, regulations, and third-party contracts. Collaborates with senior management to ensure adequate focus and resources are assigned to address compliance-related concerns. Leads and manages the investigation of issues with non-compliance and coordination of appropriate corrective action and regulatory reporting. Serves as subject matter expert to departments, and collaborates and coordinates with other subject matter experts and departments.

This position will focus on compliance for the pharmacy, utilization management, and quality of care business functions.


 Bachelors Degree Required, Masters Preferred.
• CIPP, CHC or other applicable certification preferred. Requires 5-7 years of experience in a managed care organization.

• Previous compliance program experience required.
• Experience with Medicare Advantage, Marketplace and other Commercial lines of business and their respective regulatory requirements required.
• Previous management experience preferred.

 

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Qualifications for the Compliance Manager - Health Plans Role

Overview

Implements the strategic compliance program plan into Health Plans-wide operations. Provides transformational leadership and direction to develop, recommend, and implement compliance program activities, policies, procedures, and standards in accordance with Federal and State laws, regulations, and third-party contracts. Collaborates with senior management to ensure adequate focus and resources are assigned to address compliance-related concerns. Leads and manages the investigation of issues with non-compliance and coordination of appropriate corrective action and regulatory reporting. Serves as subject matter expert to departments, and collaborates and coordinates with other subject matter experts and departments.

This position will focus on compliance for the pharmacy, utilization management, and quality of care business functions.


  • qualifications__list
     Bachelors Degree Required, Masters Preferred.
  •  CIPP, CHC or other applicable certification preferred. Requires 5-7 years of experience in a managed care organization.

  •  Previous compliance program experience required.
  •  Experience with Medicare Advantage, Marketplace and other Commercial lines of business and their respective regulatory requirements required.
  •  Previous management experience preferred.

Job Page Content image

Indiana University Health is Indiana’s most comprehensive health system, with 16 hospitals and more than 34,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.

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