Government Programs Regulatory Reporting Lead - Health Plan

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

Job summary

An established industry player is seeking a Government Programs Regulatory Reporting Lead to oversee compliance and reporting for Medicare Advantage, ACA, and Medicaid. This pivotal role involves ensuring adherence to regulations, managing data submissions, and leading process improvements. Join a dynamic team dedicated to health and healing, where you can leverage your expertise to make a significant impact on organizational compliance and operational excellence. If you have a passion for healthcare and a knack for regulatory processes, this opportunity is perfect for you.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k) Plan

Generous Time-Off Policy

Work/Life Balance Benefits

Qualifications

• 5+ years of relevant experience in healthcare or finance.
• Expertise in regulatory reporting and compliance management.

Responsibilities

• Lead regulatory reporting and audit readiness for government programs.
• Ensure compliance with State and Federal regulations.

Skills

Healthcare Regulatory Knowledge

Data Analysis

Audit Readiness

Compliance Management

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

Sanford Health

Government Programs Regulatory Reporting Lead - Health Plan Remote, South Dakota

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About Sanford Health

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

Job Details

• Facility: Remote SD (Central Time)
• Location: Remote, SD
• 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 may be required for training, team meetings, or special projects, scheduled in advance.

Job Summary

The Government Programs Regulatory Reporting Lead serves as the subject matter expert for regulated reporting and audit readiness of the Government Program products, including Medicare Advantage, ACA, and Medicaid. The role ensures compliance with all State and Federal regulations and time frames, in accordance with Sanford Health Plans policies. Responsibilities include assisting with data submissions, internal validations, managing reporting, auditing, and data exchange, and collaborating with operational units to ensure accurate product definitions, member communications, and data exchanges.

The role also involves being the main point of contact for reporting questions, leading development, implementation, process improvements, and education related to government programs. Ensures certifications, quality reporting, member materials, website content, and regulatory standards are met. Supports operational policies and procedures that promote organizational improvements and compliance. Occasional travel may be required.

Qualifications

• Bachelor's degree in healthcare, finance, or a related field.
• Minimum five years of relevant experience required.
• Experience in healthcare reimbursement or contract negotiations preferred.

Benefits

Sanford Health offers an attractive benefits package, including health, dental, vision insurance, life insurance, a 401(k) plan, work/life balance benefits, and a generous time-off policy. For more information, visit Total Rewards.

Additional Information

Sanford is an EEO/AA Employer M/F/Disability/Vet. Accommodations are available for applicants with disabilities. The employment process includes a drug screen and background check.