Note: The job is a remote job and is open to candidates in USA. EmblemHealth is a healthcare company, and they are seeking a Lead Compliance Specialist for Medicaid. The role involves ensuring compliance with regulatory requirements, providing guidance to business areas, and managing projects related to compliance initiatives.

Responsibilities

• Conduct regulatory research to address compliance inquiries
• Provide regulatory guidance and support for business process improvement efforts
• Communicate with business leadership regarding events, training, and processes related to regulatory compliance initiatives and/or memos
• Conduct monitoring and auditing of assigned business areas
• Ensure that business areas/ delegates understand and address all actionable memos or directives and upload proof of implementation to centralized Compliance Department repository
• Update and maintain centralized Compliance Department repository records as necessary and appropriate
• Support external audits or regulatory requests as needed
• Provide business areas with regulatory guidance to address and mitigate performance or monitoring gaps while ensuring regulatory requirements are met
• Support business areas in creating and updating P&Ps, trainings, reports, monitoring activities and any project related function to ensuring compliance with regulatory memos and audits by internal stakeholders, vendors, and delegates
• Contribute to Compliance Department committee and subcommittee materials as needed

Skills

• Bachelor's degree
• 5 – 8+ years' work experience in regulatory healthcare operations compliance
• Thorough knowledge of State and/or Federal programs operations and regulations
• Proficiency in the use of Microsoft Office - Word, Excel, Access, PowerPoint, Outlook, Teams, etc
• Strong organizing, prioritizing, analytical, and problem-solving skills; and outstanding attention to details
• Proven ability to establish and maintain relationships of trust with departmental staff and management
• Proven ability to coordinate and lead interdepartmental work teams and meet established goals
• Must be goal oriented and able to meet tight deadlines while handling multiple priorities
• Must be a team player and able to take direction from multiple sources
• Proven ability to effectively manage multiple tasks/projects with competing priority levels/deadlines
• Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience
• Ability to arrange work schedule to meet deadlines from multiple sources and engage staff throughout EmblemHealth to assist in the completion of duties
• Advanced degree (MPH, MHA, JD and/or MBA) and/or professional certification

Company Overview

Company H1B Sponsorship