Government Programs Regulatory Reporting Lead - Health Plan

Sanford Research; Minnesota; Remote; Full time

Job summary

A leading health system is seeking a Government Programs Regulatory Reporting Lead to ensure compliance with State and Federal regulations for Medicare Advantage, ACA, and Medicaid. The role involves managing reporting, auditing, and collaborating with operational units. Candidates should have a Bachelor's degree and five years of relevant experience. This position offers remote flexibility and a comprehensive benefits package.

Benefits

Health Insurance

Paid Time Off

401(k) Retirement Savings Plan

Employee Perks

Qualifications

• Minimum five years of relevant experience required.
• Experience in health care reimbursement or contract negotiations preferred.

Responsibilities

• Serve as subject matter expert for regulated reporting and audit readiness.
• Manage reporting, auditing, and data exchange of government programs.
• Lead in development, implementation, and process improvement.

Skills

Health Care Reimbursement

Contract Negotiations

Education

Bachelor's degree in health care, finance or a related field

Job description

Government Programs Regulatory Reporting Lead - Health Plan

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Government Programs Regulatory Reporting Lead - Health Plan

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For more information about Total Rewards, visit https://sanfordcareers.com/benefits

Sanford Health

Sanford Health Government Programs Regulatory Reporting Lead - Health Plan Remote, Minnesota

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Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

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Health Insurance

We offer multiple health plan options allowing you flexibility to choose what fits best for your family.

Paid Time Off

With our paid time off program we encourage you to take time away to re-charge and re-fresh.

Voluntary Benefits

A large assortment of voluntary benefits allow you to customize your benefit package.

Company Paid Benefits

Eligible employees receive base life insurance and disability at no cost to help with financial needs.

401(k) Retirement Savings Plan

We provide a generous employer match contribution while you put away money for your retirement.

Employee Perks

Employees get access to a wide selection of discounts/perks both local and nationwide.

Job Details

Careers With Purpose

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: Remote MN

Location: Remote, MN

Address

Shift: Varies

Job Schedule: Full time

Weekly Hours: 40.00

Salary Range: $32.50 - $52.00

Department Details

This position can remote or in office. If remote some in-person attendance will be required for training, team meetings, or special projects. These on-site responsibilities will be scheduled in advance.

Job Summary

The Government Programs Regulatory Reporting Lead will serve as the subject matter expert for regulated reporting and audit readiness of the Government Program products, including Medicare Advantage, ACA, and Medicaid, to ensure we are meeting all State and Federal regulations and time frames, and in accordance with Sanford Health Plans policies. This includes, but is not limited to assisting with questions related to data submissions, internal validations, and other task as assigned. Manages reporting, auditing, and data exchange of the government programs – Medicare Advantage, ACA, and Medicaid, in support of business objectives. Works collaboratively with operational units to ensure the products are accurately defined, communicated and configured; all member communications are compliant and data exchanges and reports are accurate, timely and meet State and Federal requirements. Serves as the main point of contact for all reporting related questions, issues, and interpretation. Leads in the development, implementation, process improvement, and education of the government program products. Leads in ensuring certifications, quality reporting, member materials and website content, and regulatory and statutory standards and requirements are met. Carries out operational policies and procedures that support organizational improvements and comply with Federal and State requirements. Other special projects as assigned. Occasional travel required.

Qualifications

Bachelor's degree in health care, finance or a related field.

Minimum five years of relevant experience required. A background or experience in health care reimbursement or contract negotiations preferred.

Benefits

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [e-mail] .

Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0220555

Job Function: Health Plan

Apply Now

Current Employees Apply Here

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