Associate Director Compliance Operations - LTC

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Job Information

Humana

Associate Director, Compliance Operations - LTC

in

Tampa

Florida

Description

The Associate Director, Compliance ensures compliance with governmental requirements. The Associate Director, Compliance requires a solid understanding of how organization capabilities interrelate across department(s).

Responsibilities

The Associate Director, Compliance develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.

Key Functions:

Creation, Development and Implementation of IOP's

Development and Implementation of actions to satisfy AHCA required LTC Reporting

Ability to work with market departments as lead representative over the Operations business area

Act as a point of escalation and resolution of operational issues

Establish and monitor key departmental metrics with SLAs

Ensure clear and documented operational procedures are in place and followed

Collaborate on all RFP/ITN activity

Demonstrated experience and implementation of Comprehensive (LTSS/MMA) state contract

LTSS Dashboard reconciliation and trouble-shooting

Work with market departments as lead representative over the Operations business area

Ensure clear and documented operational procedures are in place and followed

Provide input into the organizational strategy with particular focus on identifying opportunities to minimize risk, and to leverage operational resources to achieve goals

Management of AHCA deliverables

Collaborate with UM on EVV Vendor compliance/risk (EVV)

Management of auditing team (4-5 FTES)

Required Qualifications

Bachelor's Degree

6 or more years of technical

2 or more years of management experience

Advanced experience working in compliance, risk management, or managed-care field

Strong communication skills with the ability to influence effectively

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a  healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve. If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law.

Some Travel in the state of FL may be necessary based on business need

Preferred Qualifications

MBA, or other graduate degree

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com