What are the responsibilities and job description for the Compliance Project Manager position at Group Health Cooperative of Eau Claire?
Position Purpose
The Compliance Project Manager is responsible for the day-to-day management of specific goals and work assignments with defined outcomes, time limits, and budgets. The Compliance Project Manager position will be responsible for communicating with one or more staff to determine where they stand on current programs/projects, and update Management on program details, estimated completion dates, and other important aspects of ongoing organizational processes. The Compliance Project Manager will assist the Compliance department, and at times other departments within the Cooperative, to ensure adherence of internal and regulatory procedures, documentation, and reporting deadlines. The Compliance Project Manager may also be asked to develop responses, or, respond to, requests from outside entity audits, reviews, and/or requests for information.
Essential Functions
The Compliance Project Manager is responsible for the day-to-day management of specific goals and work assignments with defined outcomes, time limits, and budgets. The Compliance Project Manager position will be responsible for communicating with one or more staff to determine where they stand on current programs/projects, and update Management on program details, estimated completion dates, and other important aspects of ongoing organizational processes. The Compliance Project Manager will assist the Compliance department, and at times other departments within the Cooperative, to ensure adherence of internal and regulatory procedures, documentation, and reporting deadlines. The Compliance Project Manager may also be asked to develop responses, or, respond to, requests from outside entity audits, reviews, and/or requests for information.
Essential Functions
- Lead project management activities from end-to-end;
- Evaluating the scope of a project and identifying critical factors to ensure success completion;Developing detailed project plans, timelines with clear milestones and workflows to support the implementation of the project;
- Providing feedback to staff upon gauging their progress on program tasks, in order to help eliminate road blocks and ultimately report this detail to management;
- Act as primary liaison between the Compliance department and other interdisciplinary groups, by interpreting government programs related policy and contract language, and providing guidance;
- Develop and maintain strong relationships with governmental agency staff and vendors associated with the Cooperative's Medicare and Medicaid product lines;
- Coordinate the submission of regulatory reporting, including those submitted to Centers for Medicare and Medicaid (CMS) and the State of Wisconsin Department of Health Services (DHS) to ensure critical deadlines are met;
- Preparation of education materials for departments, distribution of regulatory updates including CMS. DHS, OCI and SOC memos and provider updates, and scheduling of meetings, etc.;
- Coordination of documentation for audits and site visits;
- Participate in scheduled focused meetings with teams and vendors;
Minimum Requirements of the Position
- Bachelor’s degree in Business, Health Care Administration or related field is preferred or equivalent experience required;
- Minimum one year experience in healthcare regulatory compliance is preferred;
- Knowledge of the health insurance industry required; Wisconsin Medicaid and Medicare knowledge required;
- Organized and attentive to detail;
- Proficiency with Microsoft Word, Excel, PowerPoint, and Teams
- Excellent verbal and written communication skills;
- Ability to work well with many different personality types;
Group Health Cooperative of Eau Claire complies with applicable Federal civil rights laws and does not discriminate, exclude or treat candidates less favorably on the basis of race, color, national origin (including limited English proficiency and primary language), age, disability, or sex (including sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes).
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: resumes@group-health.com. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: resumes@group-health.com. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
