Job Information
Commonwealth Care Alliance Sr. Manager, External Audit & CAP Remediation - Remote in Boston, Massachusetts
Why This Role is Important to Us:
Under direction of the Sr. Director of Regulatory & External Audits, the primary focus areas of this position includes managing external audits and resulting Corrective Action Plan (CAP). This includes audits from external regulatory agencies including but limited to Centers for Medicare & Medicaid Services (CMS), Mass Health, Departments of Insurance, and the Office of Inspector General (OIG).
Supervision Exercised:
Yes, which includes but is not limited to providing leadership, work direction, and performance feedback to subordinate staff.
What You'll Be Doing:
Oversight of CCA’s External Audit Process
Act as primary contact for regulatory auditors
Distribute requests to staff as needed
Review submissions
Develop and maintain training and requirements documentation and instructions and provide training as required
Support business units in interpretation of regulations related to their applicable areas as well as aid in developing appropriate tools to ensure compliance
Manage staff who will: (1) submit documents and responses to regulators and (2) coordinate attestations from Senior Leadership for submission
Corrective Action Plan (CAP) Management
Assign CAPs in OMT to functional leaders as needed
Monitor CAP completion to ensure timely completion
Work with Executive Leadership Team (ELT) for sign-off and validation CAPs completed
Working Conditions:
Standard office conditions.
Position requires constant operation of a computer and other office equipment (i.e., copy machine, Polycom equipment, and computer printer)
Must be able to remain in a stationary position 50 percent of the time
What We're Looking For:
Qualifications:
Bachelor's Degree or equivalent experience required,Master’s degree in health care administration, public administration, public health, or business administration preferred.
HCCA Certified in Healthcare Compliance (CHC) preferred
5 or more years direct work experience inregulatory affairs and/or compliance in Medicare or Medicaid required
5 or more years of managerial experience required
Health care industry experience required
Project management skills or equivalent required.
Required Knowledge, Skills & Abilities:
Strong written, verbal, listening and communication skills – having the ability tounderstand and communicate appropriately to the targeted audience
Strong supervisory/managerial skills.
Manage staff workload appropriately and identify areas of improvement and areasfor professional development for staff
Strong analytical skills – having the ability to identify an issue, conduct an analysis to determine business impact (including gap analyses), troubleshoot
Strong project management skills – having the ability to effectively manage multiple priorities simultaneously by maintaining established timeframes, adhering to work plans, and communicating changes effectively
Strategic thinking and planning in order to continue to enhance the ComplianceProgram and the role of compliance within the organization; ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions
Ability to influence team members and owners to resolve issues in a timely manner
Requires diplomatic and negotiation skills and understanding of needs of internal andexternal partners
Ability to work independently
Ability to present information clearly in meetings and to communicate with teammembers and senior leadership
Requires excellent interpersonal skills in order to communicate and work with staff of all skill and experience levels
Self-directed with proven initiation skills
Must be able to effectively communicate with colleagues, internal customers, and vendors
Required Language:
- English
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
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