Government Programs Regulatory Reporting Lead - Health Plan

Sanford Health; Wisconsin; Remote; Full time

Job summary

A leading healthcare organization is seeking a Government Programs Regulatory Reporting Lead to oversee compliance and reporting for Medicare Advantage, ACA, and Medicaid. This role requires strong expertise in healthcare regulations and involves collaboration across operational units. The position offers flexibility with remote work options and comprehensive benefits.

Benefits

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k)

Work/life balance benefits

Generous time off

Qualifications

• Minimum five years of relevant experience; healthcare reimbursement or contract negotiations experience preferred.

Responsibilities

• Serve as the subject matter expert for regulated reporting and audit readiness.
• Ensure compliance with State and Federal regulations.
• Lead process improvements and manage reporting.

Education

Bachelor's degree in healthcare

Bachelor's degree in finance

Bachelor's degree in a related field

Job description

Government Programs Regulatory Reporting Lead - Health Plan

Join to apply for the Government Programs Regulatory Reporting Lead - Health Plan role at Sanford Health.

Careers With Purpose

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

Facility: Remote WI

Location: Remote, WI

Shift: Varies

Job Schedule: Full time

Weekly Hours: 40.00

Salary Range: $32.50 - $52.00

Department Details: This position can be remote or in-office. If remote, some in-person attendance will be required for training, team meetings, or special projects, 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. Responsibilities include ensuring compliance with State and Federal regulations, assisting with data submissions, internal validations, managing reporting, auditing, and data exchange, and collaborating with operational units. The role involves leading process improvements, education, and ensuring certifications, quality reporting, and compliance standards are met. Occasional travel is required.

Qualifications

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

Benefits

Sanford Health offers comprehensive benefits including health, dental, vision insurance, life insurance, 401(k), work/life balance benefits, and generous time off. More details at https://sanfordcareers.com/benefits.

Sanford is an EEO/AA Employer. Accommodations available upon request. Drug-free workplace; pre-employment screening required.

Req Number: R-0220555

Job Function: Health Plan

Industry: Hospitals and Healthcare