Program Manager

GeBBS Consulting, a leader in Healthcare Technology solutions, has an immediate opening for Compliance Program Manager to support a major California-based health plan in a remote capacity.

Position Description:

Under general supervision, the Compliance Program Manager (Policy), maintains oversight responsibilities of The Health Plan’s policy program and oversees related activities to ensure compliance with federal/state laws, regulations and program standards.

What You’ll Get to Do:

• Create, update, and manage policies and procedures to ensure compliance with federal/state laws, regulations and program standards.
• Conduct regular training sessions for staff to ensure proficiency in program processes and supporting systems.
• Assess program performance and provides recommendations to corresponding oversight committee.
• Ensure all policies and procedures are up-to-date and reflective of the latest regulatory standards and updates program’s policy guide and training materials accordingly.
• Coordinate, conduct and document compliance oversight activities.
• Develop and manage work plans to ensure activities and deliverables are completed accurately and on time; negotiates or resolves issues; escalates as needed.
• Provide guidance to internal and external stakeholders to ensure understanding and compliance with regulatory, contractual, and accreditation requirements, and organization policies and procedures.
• Work collaboratively with external and internal customers to update and create new policies as needed.
• Collaborate with internal and external stakeholders to conduct routine and ad-hoc internal and external audits; identifies deficiencies that require corrective action plans.
• Coordinate/manage implementation of internal and external corrective action plans, monitoring progress and completion, coordinating interviews and document gathering; escalates as required.
• Analyze and interpret regulations, data and metrics to identify impacts, risks, opportunities, trends, variances and other insights.
• Compile, develop, and submit reports with written summaries and recommendations to management and stakeholders, including but not limited to operational issues, process changes and activity status.
• Prepare reports and supporting documentation as required by state, NCQA and other regulators.
• Monitor key industry indicators in compliance oversight, including new products and services, through relevant subject matter resources, professional associations, industry conferences, training seminars, and other information sources.
• Serve as the primary point of contact for questions related to policy program processes.

You’ll Bring these Qualifications:

• Minimum 5 years recent experience as a Compliance Program Manager (Policy) at a health plan.
• Knowledge of Medi-Cal/Medicare/D-SNP regulations, compliance a must.
• Willingness to work within the Pacific Time Zone (PST) for the duration of the engagement.
• Prior experience as a Project Manager.
• PMP certification preferred.

About GeBBS:

GeBBS Consulting has established itself as a leading technology and consulting partner for leading Health Plans, Hospitals, and many of the largest healthcare software firms. We are experts at mobilizing highly skilled teams and individual subject matter experts to assist deliver your projects on time and within budget.

Today’s healthcare industry is wildly complex and undergoing constant change. Our team of industry and technology experts will bring order to your mission critical projects and engage the necessary expertise to achieve successful delivery and completion.

Our core expertise includes:

Project / Program Management

Managed Care / Health Plan Systems

ACA / Mandates

Hospital: EMR / Clinical / Meaningful Use

HIM / Certified Professional Coders

GeBBS Consulting is an Equal Opportunity Employer.

Recruiting Fraud:

Over the past year, online recruitment scams have increased in frequency, impacting both applicants and employers. To help protect yourself against potential scammers, please note the following recruitment practices employed by GeBBS Consulting.

• GeBBS Consulting uses a single domain name for all recruiting activities and all Authorized GeBBS Consulting Recruiters use the same domain name for all email correspondences. The official GeBBS Consulting domain is gebbsconsulting.com. If you receive emails or are directed to an email other than gebbsconsulting.com, you are not responding to GeBBS Consulting.
• GeBBS Consulting screens applicants through a combination of over-the-phone, video and in-person meetings.
• GeBBS Consulting will never ask a candidate for payment of any kind as part of the hiring or onboarding process.