Essential Functions

The Manager of the Corporate Compliance Department is an administrative position with responsibility in providing direction for corporate compliance activities for Region 10.

• Serve as Corporate Compliance Officer
• Develop and Implement the PIHP Annual Compliance Plan
• Manage the Region 10 PIHP Compliance Program
• Supervise Compliance Department
• Serve as Chair of the PIHP Regulatory Compliance Committee Meetings
• Participate on Statewide Compliance Officers Workgroup
• Attend MDHHS / OIG Meetings
• Oversee MDHHS-OIG Program Integrity Reporting including:
  • Ensure quarterly submissions are timely
  • Ongoing communication to staff and Network regarding updates (as needed)
  • Education to staff and Network regarding updates (as needed)
• Provide oversight for Corporate Compliant Complaint Review and Investigation
  • Including OIG Referrals, provider fraud referrals, claims verification, site visits and complaint reporting
• Chair PIHP Corporate Compliance Committee
• Oversight all compliance investigation
  • Develop data analytic strategies for detecting fraud and abuse
  • Tract data
• Provide Oversight:
  • Primary Source Verification
  • Business Associate Agreements
  • Record Requests
  • Conflict of Interest
• Oversee external quality reviews in the area of Compliance
• Meet with regional Corporate Compliance Officers

Salary : $61,200