The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Oversees Regulatory Compliance for Elderplan health plans to ensure all industry, government and regulatory requirements are met. Develop and maintain knowledge of Elderplan plan offerings and benefits, Medicare (Parts C & D), Medicaid, MLTCP, HIPAA regulations and other applicable federal and state managed care requirements. Research current and proposed state and federal regulations and industry standards applicable to the organization; summarize and communicate regulatory and industry standards to Elderplan management and staff; and assist Elderplan management in the preparation and dissemination of regulatory requirements and updates to departments, as appropriate. Faciltiate, attend and/or participate in orgainzational committees, workgroups and meetings, as necessary, including but not limited to, the Compliance Committee, Quality Improvement Committee. Prepare regulatory compliance training and development materials. Manage all documenting, reporting and data management in the regulatory Compliance Department to ensure all required reports and data are compiled and submitted to CMS in an accurate and timely fashion. Conduct compliance audits. Recomend compliance activities (like auditing and monitoring) based on suspected or identified compliance deficiencies and/or high-risk/high-volume areas.

Bachelor's Degree required. 3-5 years' experience working in compliance, regulatory affairs or product managment in a Medicare Managed Care health plan. Expert Medicaid/Medicare regulatory knowledge required. Proficient in Word, Excel, Access DB, PowerPoint, Visio, Knowledge of CMS online system HPMS preferred.