What are the responsibilities and job description for the Director - Program Oversight (Medicare Claims) position at HCSC?
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position is responsible for directing efforts ensuring compliance with federal, state and local regulatory and contractual obligations. Responsible for the strategic development and the implementation of the system of controls to monitor and oversee the performance of Medicare claims operations, business units and delegated entities in accordance with state and federal requirements and other best practice and performance requirements. This person and team will be key participants in both internal and external audits of Medicare claims and processes. Additionally, this leader is responsible for identifying potential areas of noncompliance by conducting investigations and / or performing compliance reviews and performing risk assessments. Provides advice and guidance to operational areas regarding proper policies and procedures. Represents the company in government compliance matters as well as regulatory meetings and activities. Develops and implements business plans. Additionally, this position will collaborate with internal and external business partners to provide guidance and recommendations around the development, maintenance and enhancements of programs, products, and services. Some travel involved (10%). Please note this role is a hybrid role. This requires in-office hours 3 days a week at the respective office location.
Required Job Qualifications :
- Bachelor degree in Accounting, Business or related field.
- 8 years of auditing or investigative experience with a focus in government or compliance reviews.
- 5 years of managerial experience.
- Accounting and auditing skills.
- Management and negotiation skills.
- Effective verbal and written communication skills.
Preferred Qualifications :
LI-Hybrid
LI-AZ1
Compensation : $118,800.00 - $220,800.00
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement :
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https : / / careers.hcsc.com / totalrewards
Salary : $118,800 - $220,800
