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MetroPlus Health Plan

Integrated Products Compliance Specialist

MetroPlus Health Plan, New York, New York, us, 10261

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Job Ref:

TE0046

Category:

Professional

Department:

MHP CORPORATE COMPLIANCE

Location:

50 Water Street, 7th Floor, New York, NY 10004

Job Type:

Regular

Employment Type:

Full-Time

Work Arrangement:

Remote

Salary Range:

$93,000.00 - $103,000.00

Position Overview Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

Duties and Responsibilities

Contribute to the Annual Compliance Risk Assessment and Work Plan.

Work cross functionally with operational departments to ensure the implementation of new regulatory guidance, updated contractual requirements, rules and regulations. Tracks related due dates and guidance and support to business areas completing deliverables.

Conduct auditing and monitoring activities as outlined in Compliance Work Plan, and as potential risks are identified.

Contributes quality and timely data for the materials prepared for both the Internal Compliance Committee and Audit and Compliance Committee of the Board of Directors.

Pl a critical role in driving the progress for corrective actions throughout the organization. Upon identification of non-compliance, provide support to business areas in conducting a root cause analysis and developing corrective actions.

Conducts auditing and monitoring to ensure compliance with requirements.

Coordinates the support for business areas in creating and updating monitoring metrics to assess continued compliance with regulatory requirements.

Ensures proper investigation of regulatory compliance related issues.

Collaborates with other Compliance Specialists to support oversight of regulatory implementation across internal and external business areas for integrated product lines, ensuring alignment with applicable requirements.

Reviewing and contributing to compliance training updates as needed.

Assists Compliance division leadership in managing regulatory audits and audit deliverables. May be asked to take a lead role in sub-assignments ensuring timely and quality deliverables to State and Federal agencies.

Review policies and procedures for adherence to regulatory and contractual requirements.

Minimum Qualifications

Certified Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP) certificates are preferred

Bachelor's degree required; and

3 years' experience in compliance, product, or operational areas; or

High school diploma/GED with 8 or more years' experience in integrated and/or federal products; or

A satisfactory equivalent combination of education, training, and experience.

Advanced degree in public health, public policy, or public administration is preferred.

Experience with integrated and federal products and services highly preferred.

High-level of skill in leading interdepartmental and cross-functional strategy development and project management.

Experience leading multiple projects to ensure corporate deadlines and objectives are met.

Experience in Microsoft Office suite products including Outlook, Excel, SharePoint, and MS Teams a plus.

Professional Competencies

Integrity and Trust

Customer Focus

Functional/Technical skills

Excellent oral, written, analytical, and critical thinking skills.

Must have the utmost integrity in the handling of discreet and confidential materials.

Ability to manage multiple projects simultaneously.

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