Director of Compliance

Prominence Health; Reno (NV); Sur place; USD 120 000 - 180 000; Plein temps

Avantages offerts par ce poste

Loan forgiveness

Competitive pay

PTO

Health plans: medical, dental, vision

Résumé du poste

Prominence Health is seeking a senior compliance leader to direct and coordinate efforts ensuring adherence to Medicare and commercial regulatory requirements. The role emphasizes collaboration with health systems, providers, and regulators to maintain compliant operations.

Ideal candidates will show a strong track record in healthcare compliance, leadership, and the ability to influence across a matrix organization, with preference for Medicare Advantage and CMS audit experience.

Qualifications

• Bachelor’s degree required.
• 7–10 years in healthcare compliance, regulatory affairs, government programs, or managed care.
• Minimum 3 years of leadership experience.
• Experience with Medicare Advantage preferred.
• Experience managing CMS audits, CAPs, accreditation reviews, or insurance department examinations preferred.
• Preferred certifications: CHC, CHPC, CRCM.

Responsabilités

• Direct and coordinate Prominence’s efforts to ensure compliance with laws, regulations, and policies governing Medicare and commercial business.

Connaissances

Organizational skills

Analytical skills

Communication skills

Leadership

Formation

Bachelor’s degree

Description du poste

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/

Job Summary

Direct and coordinate Prominence’s efforts to ensure compliance with laws, regulations, and policies that govern its Medicare, and commercial business

Benefit Highlights

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications and Requirements

• Bachelor’s degree
• 7-10 years of healthcare compliance, regulatory affairs, government programs, or managed care experience.
• Minimum 3 years leadership experience.
• Experience with Medicare Advantage preferred.
• Experience managing CMS audits, CAPs, accreditation reviews, or insurance department examinations strongly preferred.
• Previous state or federal regulatory or managed care compliance experience preferred.
• Preferred Certifications: CHC, CHPC, CRCM
• Excellent organizational, judgment and analytical skills. Ability to work well both independently and with others in a matrix environment.
• Strong influencing skills and perseverance in investigating.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, governmental regulations, and legal documents. Excellent oral and written communication skills. Ability to write clear, concise reports, business correspondence, and procedures.
• Ability to effectively present and represent the plan’s interests externally with regulators.
• Ability to effectively present information and respond to inquiries from employees, regulatory agencies, and other, as necessary.
• Ability to initiate administrative activities as necessary, and institute quality control procedures.
• Ability to meet deadlines and adjust to changes in company policies, procedures, and priorities.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.