Medicare Compliance Manager, Health Plan Compliance

Kaiser Permanente

$154K — $199K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in relevant field (Health Care Administration, Law, Business, etc.)
  • Minimum 6 years in compliance or health care operations
  • At least 2 years in a leadership role (with or without direct reports)
  • Experience in privacy and security compliance preferred
  • Supervisory experience is a plus.

Responsibilities

  • Manage company compliance activities with internal and external stakeholders.
  • Oversee compliance reporting efforts and analysis of compliance data.
  • Conduct compliance investigations, leading interviews and evaluating data.
  • Translate business plans into tactical actions for the work unit.
  • Manage projects related to compliance and stakeholder engagement.
  • Monitor and interpret regulatory changes to guide business strategy.
  • Develop and implement compliance training and standards.

Benefits

  • Remote work available
  • Full-time position with a consistent schedule
  • Developmental opportunities for professional growth
  • Fostering diversity, equity, and inclusion in the workplace
  • Comprehensive total rewards package including health and retirement benefits.
Full Job Description
Job Summary:
This manager level position is primarily responsible for managing company compliance activities in partnership with internal and external stakeholders and managing strategic compliance initiatives. Responsibilities include managing compliance reporting efforts, compliance investigation, and activities associated with continued regulatory compliance across one or more business functions. Additional key responsibilities include managing the implementation of compliance efforts through monitoring, interpreting, and designing strategy around regulatory changes. This managing level employee also manages projects or compliance components of larger cross-functional projects including identifying and managing stakeholders.

Essential Responsibilities:
  • Pursues professional growth and provides developmental opportunities for others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; training and developing talent for growth opportunities; delegating tasks and decisions; fostering open dialogue amongst team members; executing performance management guidelines and expectations; and working closely with employees to set goals and provide open feedback and coaching to drive performance improvement.
  • Manages designated work unit by translating business plans into tactical action items; ensuring all policies and procedures are followed; delegating tasks to meet goals and objectives; overseeing the completion of work assignments; aligning team efforts; building accountability for and measuring progress in achieving results; identifying and addressing improvement opportunities; removing obstacles that impact performance; and guiding performance and developing contingency plans accordingly.
  • Manages company compliance activities by partnering with internal and external stakeholders; applying established regulations and standards to compliance efforts; managing the design, development, and execution of strategic compliance initiatives; overseeing the analysis of regulations and regulatory changes, and their application to operations; and overseeing the documentation of compliance activities.
  • Manages compliance reporting efforts across one or more business functions by managing the evaluation and summary of compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to senior management; and developing complex presentations to convey key findings to leadership and external business stakeholders.
  • Manages compliance investigations across one or more business functions by managing the collection and analysis of quantitative and qualitative data; leading interviews as appropriate; researching key business issues; and evaluating and recommending corrective action plans for substantiated allegations.
  • Manages projects or compliance components of larger cross-functional projects by identifying and managing stakeholder contacts; assembling teams based on project needs and team member strengths; developing, analyzing, and managing project plans; negotiating and managing project schedules and resource forecasts; and managing project financials and deliverables.
  • Manages activities associated with continued regulatory compliance for one or more business functions by monitoring, interpreting, and designing strategy around regulatory changes; determining the impact of changes to the business; providing direction on implementation of changes throughout the organization; and providing regulatory input before and during inspections to minimize the risks of future non-compliance.
  • Manages the implementation of compliance efforts by approving compliance requirements; ensuring the assessment of current state compliance to identify gaps and corrective actions; managing the analysis and development of complex compliance standards, policies and procedures, and training; and ensuring and monitoring ongoing compliance adherence.
Knowledge, Skills and Abilities: (Core)
  • Ambiguity/Uncertainty Management
  • Attention to Detail
  • Business Knowledge
  • Communication
  • Constructive Feedback
  • Critical Thinking
  • Cross-Group Collaboration
  • Decision Making
  • Dependability
  • Diversity, Equity, and Inclusion Support
  • Drives Results
  • Facilitation Skills
  • Health Care Industry
  • Influencing Others
  • Integrity
  • Leadership
  • Learning Agility
  • Organizational Savvy
  • Problem Solving
  • Short- and Long-term Learning & Recall
  • Strategic Thinking
  • Team Building
  • Teamwork
  • Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)
  • Analytical Skills
  • Compliance Management
  • Cross Department Coordination
  • Getting Work Done Through Others
  • Negotiation
  • Project Management
  • Technical Communication
  • Written Communication

Minimum Qualifications:
  • Bachelors degree in Health Care Administration, Clinical, Law, Public Health, Business or related field and Minimum six (6) years experience in compliance, health care operations (quality, risk, etc.), audit, finance, regulatory or public policy development, investigations, information security, or insurance/health plan governance or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.
  • Minimum two (2) years experience in a leadership role with or without direct reports.
Preferred Qualifications:
  • Two (2) years supervisory experience.
  • Four (4) years experience in privacy and security compliance.


Primary Location: California,Oakland,Ordway
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:01 AM
Working Hours End: 05:01 PM
Job Schedule: Full-time
Job Type: Standard
Employee Status: Regular
Worker Location: Remote
Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee
Job Level: Manager with Direct Reports
Department: Po/Ho Corp - Compliance Health Plan - 0308
Pay Range: $154000 - $199210 / year Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: No

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