AVP, Medicare and Regulatory Compliance

Are you looking for your next opportunity?

Sompo has a unique opportunity for an AVP, Medicare and Regulatory Compliance in our Claims Compliance and Governance team.

Our Claims Compliance and Governance Team provides support to the North American Operations with adherence to regulatory and compliance data reporting that will strengthen implementation and enhancement of overall claims transformation. We closely support multiline disciplines with meeting statutory and regulatory requirements that compliment proactive controls that are in place.

Location: This position can be based out of our Alpharetta, GA, Charlotte, NC or Denver, CO office. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers.

Our Business, Your Impact, Our Opportunity

What you’ll be doing:

• Lead and support regulatory and compliance including Medicare/CMS and statutory compliance
• Manage Medicare regulatory reporting of Medicare Section 111 Reporting and MSA submissions
• Revise and enhance claims compliance guides and resources to reflect changes in state regulations
• Strategically direct, analyze, and resolve complex compliance issues related to Medicare, state reporting, DOI requests and market conduct audits
• Deliver consistent and high-quality level of claims service to our internal and external clients
• Oversee and manage Medicare reporting processes, ensuring timely and accurate CMS error corrections
• Deliver expert technical training and administration in Regulatory and Compliance
• Conduct comprehensive compliance audits as needed, ensuring a thorough evaluation of regulatory adherence
  
  

What You’ll Bring

• Minimum 8-10 years’ experience in commercial P&C compliance and regulatory reporting
• Knowledgeable in Medicare compliance, administration and industry state reporting
• Proven capability to offer business insights in large, complex, and multi-disciplinary systems implementation projects
• Ability to understand multidiscipline lines of business that support data requirements for state and regulatory reporting
• Proficiency leveraging data analysis tools and techniques to extract meaningful data
• Commitment to delivering exceptional client service and fostering strong client relationships
• Strategic problem-solving and decision-making capabilities with a robust work ethic and dynamic energy
• Undergraduate degree or demonstrable industry experience
• Technical skillsets in Claims Management systems, PowerBI tools, MS Office Suite, and Visio
  
  

Salary Range: $105,000 – $175,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience.

At Sompo, we recognize that the talent, skills, and commitment of our employees drive our success. This is why we offer competitive, high-quality compensation and benefit programs to eligible employees.

Our compensation program is built on a foundation that promotes a pay-for-performance culture, resulting in higher incentive awards, on average, when the Company does well and lower incentive awards when the Company underperforms. The total compensation opportunity for all regular, full-time employees is a combination of base salary and incentives that gets adjusted upfront based on overall Company performance with final awards based on individual performance.

Summary

We continuously evaluate and update our benefit programs to ensure that our plans remain competitive and meet the needs of our employees and their dependents. Below is a summary of our current comprehensive U.S. benefit programs:

• Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution
• Pharmacy benefits with mail order options
• Dental benefits including orthodontia benefits for adults and children
• Vision benefits
• Health Care & Dependent Care Flexible Spending Accounts
• Company-paid Life & AD&D benefits, including the option to purchase Supplemental life coverage for employee, spouse & children
• Company-paid Disability benefits with very competitive salary continuation payments
• 401(k) Retirement Savings Plan with competitive employer contributions
• Competitive paid-time-off programs, including company-paid holidays
• Competitive Parental Leave Benefits & Adoption Assistance program
• Employee Assistance Program
• Tax-Free Commuter Benefit
• Tuition Reimbursement & Professional Qualification benefits
  
  

In today’s world, what do we stand for?

Ethics and integrity are the foundation of delivering on our commitment to you. We believe that core values drive success, and that when relationships are held in the highest regard, there is nothing that cannot be accomplished. At Sompo, our ring is more than a logo, it is a symbol of our promise. Click here to learn more about life at Sompo.

Sompo is an equal opportunity employer and we intentionally value inclusion and diversity. Above all, we want you to work in an environment that respects everyone’s unique contributions – we are passionately committed to equal opportunities. We do not discriminate based on race, color, religion, sex orientation, national origin, or age.