Senior Medicare Compliance Consultant

Banner Health; Lansing (MI); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player in healthcare is seeking a Senior Medicare Compliance Consultant to join their dynamic team. This fully remote position offers the opportunity to coordinate compliance programs and manage sensitive matters related to Medicare Advantage. You will play a crucial role in ensuring adherence to regulations while providing support to leadership and staff. The ideal candidate will possess strong communication skills and a solid background in healthcare compliance. If you are passionate about making a difference in the healthcare sector, this role is perfect for you.

Qualifications

• 5+ years of experience in healthcare compliance or equivalent education.
• Strong knowledge of laws and regulations related to healthcare compliance.

Responsibilities

• Monitor Medicare Advantage compliance and operational control measures.
• Manage compliance-related questions and governmental audits.

Skills

Healthcare Compliance Knowledge

Problem-Solving Skills

Planning Skills

Oral Communication Skills

Written Communication Skills

Education

Bachelor's Degree in Business Administration

Bachelor's Degree in Accounting/Finance

Bachelor's Degree in Health Care Related Field

Master's Degree (Preferred)

Job description

Senior Medicare Compliance Consultant

Apply: Remote

Locations: Remote Arizona, Remote Wisconsin, Remote Wyoming, Remote Washington, Remote Virginia

Time Type: Full time

Posted On: 5 Days Ago

Job Requisition ID: R4382859

Primary City/State: Arizona

Department Name: Compliance-Corp

Work Shift: Day

Job Category: Compliance

Primary Location Salary Range: $40.91 - $68.19 / hour, based on education & experience

In accordance with State Pay Transparency Rules.

You have a place in the health care industry. At Banner Health, caring for people is at the core of all we do. We are committed to diversity, equity and inclusion. If that sounds like something you want to be a part of - apply today!

The schedule for this role is 5/8’s, 8:00 AM – 5:00 PM (AZ Time). In this position, you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight is in place for accurate, complete, and compliant activities. This team highly values experience with:

1. Monitoring internal operational control measures ensuring appropriate oversight is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D.
2. Identifying and documenting all noncompliance related activities and reports accordingly in a timely fashion.
3. Working in a start-up environment.
4. Medicare Advantage Compliance training, audits, regulations, and manuals.
5. Reviewing Policy and Procedures.
6. Ensuring reporting requirements are maintained in a timely and accurate fashion, including the resolution of each case/issue identified and closed.
7. Participating in the preparation of presentation materials designed specifically to communicate and promote the understanding of compliance.
8. Overseeing the thorough documentation of all compliance and noncompliance related activities.

This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WV, WA, WI & WY.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines.

POSITION SUMMARY: This position coordinates Banner’s Compliance Program and its related policies, procedures, processes, and activities. Based on area of assigned responsibility, assists in actively managing compliance-related matters by region, business area or facility.

CORE FUNCTIONS:

1. Manages highly complex and sensitive questions, concerns, and complaints related to compliance matters, providing answers and support to leadership.
2. In consultation with others in the Compliance and Legal Departments, manages Banner’s response to governmental audits, investigations, or inquiries.
3. Supports the compliance management staff by responding to questions or concerns, researching matters of note, and providing training as necessary.
4. Stays knowledgeable on current compliance-related laws and regulations through personal initiative, seminars, training programs, and peer contact.
5. This position interacts with a multitude of executive and senior management, physicians, and staff throughout Banner.

MINIMUM QUALIFICATIONS:

Must possess a strong knowledge of business and/or health care compliance as normally obtained through the completion of a bachelor’s degree in business administration, accounting/finance, or health care related field. Must also possess five plus years of current and progressive experience in healthcare compliance or an equivalent combination of relevant education and experience.

Requires knowledge of laws and regulations pertaining to health care, regulatory compliance, Medicare/Medicaid and/or financial reimbursement systems.

Must possess strong planning skills and problem-solving skills. Must possess strong oral and written communication skills to effectively interact with senior management team, physicians, and federal and state governing bodies.

PREFERRED QUALIFICATIONS:

Master's degree and/or professional designations preferred. Previous payer, health care or academic compliance experience preferred as relevant.

Anticipated Closing Window: 2025-05-07

EEO Statement: EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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We are proud to offer a comprehensive benefit package for all benefit-eligible positions. Please visit our Benefits Guide for more information.

Banner Health supports a drug-free work environment.