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Telligen एक स्वास्थ्य सेवा और बीमा कंपनी है, जो अमेरिका की सरकारी स्वास्थ्य एजेंसियों, Medicaid कार्यक्रमों, स्वास्थ्य योजनाओं, नियोक्ताओं और प्रबंधित देखभाल संगठनों के साथ काम करती है। इसकी सेवाओं में स्वास्थ्य सेवा विशेषज्ञता के साथ डेटा विश्लेषण, गुणवत्ता मापन, कार्यक्रम प्रबंधन, स्वास्थ्य सूचना प्रौद्योगिकी, उपयोग प्रबंधन, देखभाल प्रबंधन और स्वास्थ्यवर्धक कार्यक्रम शामिल हैं। Telligen बेहतर स्वास्थ्य परिणामों और जनसंख्या स्वास्थ्य प्रबंधन पर केंद्रित राष्ट्रीय तथा बहु-राज्यीय गुणवत्ता सुधार पहलों का भी समर्थन करती है।
Senior Contracts and Compliance Manager, Medicaid Programs
Lead contract compliance for Telligen’s Tailored Care Pathways program, turning Medicaid requirements into practical policies and processes. The role covers audits, reporting, risk management, and corrective actions.
विवरण
- Lead contracting and compliance for Telligen’s Tailored Care Pathways program.
- Advise program teams and provide subject matter expertise.
- Act as the primary contact for company contracting activities.
- Ensure TCMP services are delivered, documented, and reported in line with HFS policies and the Williams and Colbert Consent Decree.
- Create and maintain compliance policies, procedures, and processes.
- Translate contract terms, policies, and program guidance into operational procedures and compliance activities.
- Review program operations and records for compliance, identifying needed follow-up or corrective action.
- Work with program leaders and operations teams to address compliance concerns.
- Maintain records that demonstrate contractual, regulatory, and program compliance.
- Help prepare, review, and submit required reports, records, and contract deliverables.
- Track changes to HFS policies, contracts, and program guidance, updating internal procedures as needed.
- Support audits, monitoring, and compliance reviews, both internal and external.
- Assess compliance risks and process improvements, and recommend preventive or corrective measures.
- Follow compliance issues and corrective actions through resolution.
- Educate staff on contract terms, policies, procedures, and compliance expectations.
- Partner with internal teams to apply TCMP requirements consistently.
आवश्यकताएँ
- Bachelor’s degree in business administration, healthcare administration, public administration, compliance, or a related area, or equivalent experience.
- At least seven years of experience in contract compliance, healthcare program administration, regulatory compliance, quality management, or a related field.
- Experience with healthcare regulatory compliance and Medicaid programs.
- At least one year leading or managing staff in compliance or contracting.
- Ability to interpret contracts, policies, regulations, and program guidance and convert requirements into operational procedures and compliance activities.
- Strong analytical, organizational, documentation, problem-solving, customer service, and communication skills.
- Ability to handle competing deadlines and work across functions.
- Proficiency with Word, Excel, Adobe Acrobat, and database or customer relationship management systems.
- Ability to manage multiple requirements, deadlines, and compliance activities at once.
- Ability to collaborate with program, operations, quality, and leadership teams.
- Ability to travel overnight 5% to 10% of the time.
- NCMA certification preferred.
- Knowledge of applicable OMB policies and Federal Acquisition Regulations preferred.
लाभ
- Benefits package detailed in Telligen’s Benefits Summary.
- Employee-owned company where employees share in its success.
- Equal opportunity employer.
- Reasonable accommodations available during the employment process.
- Work authorization sponsorship is not provided.
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