Government Programs Regulatory Reporting Lead - Health Plan

Good Samaritan Society; Wisconsin; 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 and audit readiness for government programs. This role offers the opportunity to drive improvements in regulatory reporting processes while collaborating with operational units. Ideal candidates will have a strong background in healthcare finance and regulatory compliance, along with a passion for making a difference in the healthcare landscape. Join a team that values growth and offers an attractive benefits package, including health and wellness programs, work/life balance benefits, and generous time off.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k) Plan

Generous Time Off

Work/Life Balance Benefits

Qualifications

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

Responsibilities

• Lead compliance with State and Federal regulations for government programs.
• Manage reporting, auditing, and data exchange for Medicare and Medicaid.

Skills

Regulatory Reporting

Audit Readiness

Healthcare Reimbursement

Data Validation

Education

Bachelor's degree in healthcare

Bachelor's degree in finance

Job description

Government Programs Regulatory Reporting Lead - Health Plan | Sanford Careers

Sanford Health

Government Programs Regulatory Reporting Lead - Health Plan Remote, Wisconsin

Apply Now | Current Employees Apply Here

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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.

Facility: Remote WI
Location: Remote, WI
Address: [Address to be provided]
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, scheduled in advance.

Job Summary

The Government Programs Regulatory Reporting Lead serves as the subject matter expert for regulated reporting and audit readiness of government program products, including Medicare Advantage, ACA, and Medicaid. The role ensures compliance with all State and Federal regulations and timelines, in accordance with Sanford Health Plans policies. Responsibilities include assisting with data submissions, internal validations, and other related tasks. The role manages reporting, auditing, and data exchange of government programs, collaborating with operational units to ensure accurate product definitions, member communications, and compliant data exchanges and reports. The Lead 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 supporting organizational improvements and compliance. Occasional travel may be required.

Qualifications

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

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

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you require accommodations during the application process, please contact 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 prior to employment.