Government Programs Regulatory Reporting Lead - Health Plan

Good Samaritan Society; North Dakota; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a Government Programs Regulatory Reporting Lead to ensure compliance with State and Federal regulations. This role involves managing reporting and auditing for Medicare Advantage, ACA, and Medicaid programs while collaborating with various operational units. The ideal candidate will have a strong background in healthcare reimbursement and regulatory reporting, contributing to the organization's mission of health and healing. Join a dynamic team dedicated to making a difference in the healthcare landscape, with opportunities for professional development and a comprehensive benefits package.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Generous Time Off

Work/Life Balance Benefits

Qualifications

• 5+ years of experience in regulatory reporting and audit readiness.
• Strong background in healthcare reimbursement preferred.

Responsibilities

• Manage reporting, auditing, and data exchange for government programs.
• Collaborate with operational units to ensure compliance and accurate definitions.

Skills

Regulatory Reporting

Audit Readiness

Healthcare Reimbursement

Contract Negotiations

Education

Bachelor's Degree in Healthcare

Bachelor's Degree in Finance

Related Field Degree

Job description

Government Programs Regulatory Reporting Lead - Health Plan | Sanford Careers

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

Job Information

Sanford Health Government Programs Regulatory Reporting Lead - Health Plan in Remote, North Dakota

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 ND (Central Time)
Location: Remote, ND
Address:
Shift: Varies
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $32.50 - $52.00

This position can be 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 compliance with all State and Federal regulations and deadlines, in accordance with Sanford Health Plans policies. Responsibilities include assisting with data submission questions, internal validations, and other tasks as assigned. The role manages reporting, auditing, and data exchange for Medicare Advantage, ACA, and Medicaid programs, supporting business objectives. It involves collaboration with operational units to ensure accurate product definitions, communication, configuration, and compliance of member communications, data exchanges, and reports. The position acts as the main contact for reporting questions, issues, and interpretation, and leads in developing, implementing, and improving processes related to government programs. Ensures certifications, quality reporting, member materials, website content, and regulatory standards are met. Implements operational policies and procedures supporting organizational improvements and compliance. Other special projects may be assigned. Occasional travel is required.

Qualifications

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

Minimum of five years of relevant experience required. Background or experience in healthcare reimbursement or contract negotiations is preferred.

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees, including health, dental, vision insurance, life insurance, a 401(k) plan, work/life balance benefits, and generous time off. For more information about Total Rewards, visit https://sanfordcareers.com/benefits.

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are a person with a disability and require assistance with your online application, please call 1-877-673-0854 or email [e-mail].

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