Health Plan Compliance Officer, Michigan

McLaren Health Care; Flint (MI); Hybrid; USD 120,000 - 180,000; Full time

Job summary

McLaren Health Care is seeking a Compliance Officer to lead the organization’s compliance, program integrity and security efforts across McLaren Health Plan and its subsidiaries. This role directs development, implementation and oversight of the overall compliance program.

The Compliance Officer serves as Chair of the Compliance Committee, reporting to the Market President and the Board of Directors, and ensures ongoing adherence to laws, regulations and internal policies while fostering an

Qualifications

• Bachelor's degree in business, health care, or related field.
• Five (5) years in a senior HMO/TPA leadership role with demonstrated knowledge of Health Maintenance Organizations/Insurance functions.
• Master's degree in business, health care, or related field.
• Certified in Health Care Compliance (CHC).
• Previous experience as a Compliance Officer.

Responsibilities

• Oversee all compliance activities and program integrity for MHP and subsidiaries.
• Develop, implement, document and oversight of McLaren Health Plan and its subsidiaries (MHP) compliance, program integrity, and security program.
• Chair the Compliance Committee and have direct access to the Market President and Board of Directors.

Education

Bachelor's degree in business, health care, or related field

Master's degree in business, health care, or related field

Job description

The McLaren system includes 12 hospitals across the state, ambulatory surgery centers, imaging centers, a 730-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 242,000 Michigan lives, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network, and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer center. McLaren has 20,000 full-, part-time and contracted employees and more than 93,000 network providers throughout Michigan.

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives.We are looking for a Compliance Officer to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member.MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life.McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP,you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

Position Summary: The Compliance Officer is responsible for overseeing all compliance activities and is responsible for development, implementation, documentation and oversight of McLaren Health Plan and its subsidiaries (MHP) compliance, program integrity, and security program.Directs and coordinates MHP’s efforts to ensure continued compliance with laws, regulations, and policies that govern all lines of business.Serves as Chair of the Compliance Committee and shall have direct access to the Market President and Board of Directors.

Qualifications:

Required:

• Bachelor's degree in business, health care, or related field; or Associate degree and two (2) years' related experience.
• Five (5) years in a senior HMO/TPA leadership role with demonstrated knowledge of Health Maintenance Organizations/Insurance functions (marketing/sales, finance, administration, claims, business information reporting and systems, regulatory compliance).

Preferred:

• Master's degree in business, health care, or related field.
• Certified in Health Care Compliance (CHC).
• Previous experience as a Compliance Officer.

Additional Information

• Schedule: Full-time
• Requisition ID: 26011423
• Daily Work Times: 8:30 AM - 5:00 PM
• On Call: No

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.

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McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status,national origin, disability, genetic information, height or weight, protected veteran or other classificationprotected by law.