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SalaryAt Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!
Job Description
A bit about this role:
- As a Senior Compliance Analyst, you will be reporting to a Senior Manager within the Compliance Department.
- Our team is responsible for our External Compliance (FDR and Part D), as well as those Internal Business Areas related to External Compliance (Correspondence Operations, Delegated Operations, Integrations Operations, Offshore Operations, and Provider Operations).
- Our team works closely with Compliance Department colleagues that support our Business, Clinical, FWA/SIU, Part C, and Sales/Marketing Compliance teams.
- In this role, you will be closely connected to all aspects of driving and maintaining Internal and External Compliance. You will take on the task of directly working to ensure all our Internal and External Partners meet or exceed the required standards of compliance.
- You will have primary responsibility for the daily oversight activities of our Delegated Credentialing compliance, including leading regular meetings with our Credentialing operations, and tracking non-compliant issues to closure.
- You will have primary responsibility for the implementation of our FDR Audit Workplan, developing and conducting audits, and performing ongoing oversight/monitoring activities of our FDRs to ensure compliance standards are met, and to track and bring to remediation disclosed/identified non-compliance.
- You will also develop and maintain reports, documents, tools, and tech solutions to drive our Compliance Program’s Effectiveness.
Your Responsibilities and Impact will include:
- Delegated Credentialing Oversight activities may include daily monitoring tasks, ensuring required actions are taken regarding new delegations, amended contracts, etc.,
- FDR Auditing activities may include participating in the annual risk assessment and audit work plan, conducting audit activities and drafting/issuing comprehensive Audit Reports, drafting Corrective Action Plans for identified non-compliant issues and tracking to closure, etc.
- FDR Oversight & Monitoring activities may include FDR onboarding/offboarding processes (e.g., FDR Determinations, Attestations, Terminations, Offshore Requests, and related HPMS Module Maintenance), FDR Call Quality Calibrations, regular CPEs/COAs, drafting Corrective Action Plans for identified non-compliant issues and tracking to closure, etc.
- FDR Compliance Program Effectiveness activities may include:
- Develop and maintain Reports, Standard Operating Procedures, Policies and Procedures, Audit Tools, Tech Solutions, etc.
- Analyze data and develop/maintain related dashboards/trackers to identify trends/risks and make appropriate conclusions based upon guidelines
- Review HPMS memos and regulatory guidance for adherence to regulatory processes
- Respond to day-to-day operational compliance questions
Required skills and experience:
- Role-specific:
- General knowledge of health plan compliance, operations, standards, policies and/or procedures for Medicare Advantage, Medicaid, and/or Commercial plans
- Ability to evaluate compliance issues, seek additional guidance when necessary, and make appropriate recommendations
- Confidence in ability to balance the goals of the business within the requirements of external regulatory agencies
- Problem solving skills with the ability to look for root causes and identify process improvement opportunities
- In general:
- Professional verbal and written communication skills
- Organizational skills with the ability to handle multiple tasks and/or projects
- Ability to meet strict deadlines
- Ability to work in a fast-paced environment
- Experience working remotely
- Ability to Travel 10-20% (onsite meetings, audits, and conferences)
Desired skills and experience:
- Proficiency in:
- Google Suite / Workspace / ChromeOS
- Atlassian (Jira/Confluence)
- Slack
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#LI-Remote
Salary Range:$57,000 - $120,000 / year
#LI-Remote
Salary Range:$57,000 - $120,000 / year
Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.
Our Total Rewards package includes:
- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
- Parental leave program
- 401K program
- And more....
- Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
