Senior Manager Medicaid Contract Compliance

Requisition ID: 863150 
Position:Full-Time
Total Rewards: Benefits/Incentive Information

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, and Target 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.

GENERAL FUNCTION

The Sr. Manager – Contract Compliance for Medicaid is responsible for supporting EyeMed’s Medicaid business operations and the implementation of operational, reporting, and regulatory requirements in assigned states. The Sr. Manager provides state specific Medicaid compliance guidance and supports business areas in the in the implantation of aligned business requirements. This role maintains a broad understanding of individual state Medicaid contracts, EyeMed’s client specific Medicaid contracts, as well as state and federal requirements impacting EyeMed’s Medicaid business.

MAJOR DUTIES AND RESPONSIBILITIES

• Maintains in-depth knowledge of assigned state Medicaid contract requirements and sub-requirements to serve as a resource to internal and external stakeholders. 
• Monitors evolving Medicaid requirements and sub-requirements across assigned states and assists EyeMed’s business operations with implantation of new and revised requirements.
• Supports the development of EyeMed’s Medicaid policies and procedures by providing guidance on relevant requirements. Ensures Medicaid related materials, manuals, policies, and procedures are compliant with current requirements and sub-requirements; routinely updates as necessary.
• Conducts research on Medicaid compliance topics and responds to Medicaid compliance questions.
• Manages the development and execution of corrective action plans for EyeMed’s Medicaid business. Tracks activities and progress against corrective action plan requirements and deadlines. Reviews evidence of remediation completion. 
• Monitors delivery of contractual / required Medicaid reporting, ensures timeliness, and reviews report templates to confirm general data descriptions align with Medicaid requirements and sub-requirements.
• Actively participates in applicable working groups and committees related to areas of responsibility.

BASIC QUALIFICATIONS

• Bachelor’s degree, preferably in Public Policy, Governmental Affairs, Health Care Administration, or Public Administration
• 7 years regulatory compliance position in managed care, health care, or insurance
• 3 years direct experience in Medicaid compliance
• Working knowledge of Medicaid requirements, standards, and processes
• Experience with Medicaid reporting
• Exceptional verbal and written professional communication skills
• Strong analytical, research, and project management skills 

PREFERRED QUALIFICATIONS

• Experience with CMS compliance reporting requirements
• 3 years project management experience or Project Management Professional (PMP) Certification
• Masters Degree in a related field
• Certificate in Healthcare Compliance

Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts.

Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com. 

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, 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. Native Americans in the US receive preference in accordance with Tribal Law. 

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