Job Description:

RESPONSIBILITIES:

Kforce has a client that is seeking a Senior Compliance Manager in San Antonio, TX.

Summary:
The Senior Compliance Manager, Medicare, Marketplace, and Commercial is responsible for the administration, integration, and oversight of compliance in operational areas, including delegated activities and regulatory reporting. This position reports to the Director of Compliance & Risk Management and must be knowledgeable about current Texas Department of Insurance (TDI) regulations and Centers for Medicare and Medicaid Services (CMS) regulations.

As the compliance lead for Medicare, Marketplace, and Commercial lines of business, the Senior Compliance Manager coordinates and facilitates the execution of the organization's regulatory deliverables. The role involves familiarity with Texas Medicaid regulations, the Texas Department of Health and Human Services Commission (HHSC) contract, and the Office of Inspector General (OIG) Compliance Plan.

Functions/Behaviors:

• Regulatory Deliverables Coordination: Facilitate the filing of all regulatory deliverables for Medicare, Marketplace, and Commercial lines of business (E, 20%)


• Regulatory Monitoring: Monitor and communicate regulatory requirements impacting business lines, initiating communication and solutions with affected operational areas (E, 20%)


• Ongoing Compliance Monitoring: Monitor compliance within designated lines of business and assist team members as needed (E, 10%)


• Operational Weakness Identification: Identify potential weaknesses within operational areas, suggesting improvements for processes and reporting (E, 10%)


• Deadline Management: Ensure all deadlines for deliverables are on track, assisting operational areas as needed (E, 10%)


• Support for Director and Compliance Managers: Assist the Director and other Compliance Managers as needed (E, 10%)


• Investigation Coordination: Assist with coordinating internal and external investigations as required (E, 10%)

REQUIREMENTS:

• A Bachelor's degree in Business Administration, Public Administration, Healthcare Administration, or a related field is required; Alternatively, a minimum of five years in the managed care industry may substitute for college education


• Proficiency in Microsoft Office applications is required


• Must be a self-starter, be able to lead and manage a team, and communicate effectively

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless
and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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