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Corporate Compliance Manager

Region 10 PIHP -
Port Huron, MI

Quick Apply

Job Details

Full-time
From $61,200 a year

Benefits

Paid holidays
Health insurance
Paid time off

Qualifications

Microsoft Word
Microsoft Excel
Presentation software
Team leadership
Writing skills
Word embeddings
Master's degree
Driver's License
Supervising experience
Health insurance knowledge
Medical credentialing
Leading team collaboration initiatives
Regulatory submissions
Managing projects
Medicaid regulations
Medicaid
Project leadership
Data analytics technologies

Full Job Description

Essential Functions

The Manager of the Corporate Compliance Department is an administrative position with responsibility in providing direction for corporate compliance activities for Region 10.

Serve as Corporate Compliance Officer
Develop and Implement the PIHP Annual Compliance Plan
Manage the Region 10 PIHP Compliance Program
Supervise Compliance Department
Serve as Chair of the PIHP Regulatory Compliance Committee Meetings
Participate on Statewide Compliance Officers Workgroup
Attend MDHHS / OIG Meetings
Oversee MDHHS-OIG Program Integrity Reporting including:
- Ensure quarterly submissions are timely
- Ongoing communication to staff and Network regarding updates (as needed)
- Education to staff and Network regarding updates (as needed)
Provide oversight for Corporate Compliant Complaint Review and Investigation
- Including OIG Referrals, provider fraud referrals, claims verification, site visits and complaint reporting
Chair PIHP Corporate Compliance Committee
Oversight all compliance investigation
- Develop data analytic strategies for detecting fraud and abuse
- Tract data
Provide Oversight:
- Primary Source Verification
- Business Associate Agreements
- Policy development and reviews
- Conflict of Interest
Oversee external quality reviews in the area of Compliance
Meet with regional Corporate Compliance Officers

Minimum Qualifications (An employee must have the following credentials, training, and experience)

Master’s Degree in behavioral health or related field

Experience in the area of Corporate Compliance

Two years of experience supervising staff

Experience working at Pre-Paid Inpatient Health Plan (PIHP), Community Mental Health (CMH) or SUD provider agency

Experience with privileging and credentialing

Knowledge of the Michigan Medicaid Provider Manual

Experience in writing reports, analyzing data and administrative projects

Ability to be a “work leader” (of a person or function), or advise others

Experience in managing projects and teams

Excellent organizational and writing skills

Demonstrated knowledge of Microsoft Word and Excel

Ability to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoided

Ingenuity is required to adapt, alter, or improvise alternatives when unexpected situations occur

Ability to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcome

Ability to use or exert influence in a work process

Ability to provide, exchange or explain information which conveys an opinion or evaluation of the facts or analyses

Ability to develop and/or maintain effective work relationships with new, established, or non-receptive individuals/organizations through tact, diplomacy, and persuasion

Basic knowledge of MDHHS reporting

Basic knowledge of State of Michigan Medicaid Provider Manual

Valid State of Michigan Driver’s License

Must have access to transportation

Preferred Qualifications

Five years of experience supervising staff

Five years of experience working in Corporate Compliance

Experience with Microsoft PowerPoint

Advanced knowledge of MDHHS PIHP/CMH reporting

Advanced knowledge of State of Michigan Medicaid Provider Manual

$1500 Sign-On Bonus available

Overview: Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. $1500 sign-on bonus available. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 13 paid holidays, flexible scheduling, and a comprehensive benefit program.

NOTICE TO APPLICANTS

When applying, be sure to include evidence that the minimum qualifications are met (resume, copy of license, copy of educational transcripts, description of years of experience, skill-based experience/training, letters of reference, etc.).

This position will be hired as employment-at-will.

Any offer of employment is contingent upon a Criminal Background Check, as well as a 5 Panel Drug Screen.

Region 10 PIHP embraces an employment environment that promotes recovery and discovery, a person-centered approach to treatment/services, and cultural competence. An employee in this or any position is expected to support the employment environment.

Region 10 PIHP provides equal employment opportunities (EEO) to applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Region 10 PIHP complies with applicable state and local laws governing nondiscrimination in employment.

Quick Apply

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Essential Functions

Minimum Qualifications (An employee must have the following credentials, training, and experience)

Preferred Qualifications

NOTICE TO APPLICANTS

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