Telligen
Telligen
Telligen este o companie de servicii medicale și asigurări care colaborează cu agenții guvernamentale de sănătate din SUA, programe Medicaid, planuri de sănătate, angajatori și organizații de îngrijire medicală administrată. Serviciile sale combină expertiza în domeniul sănătății cu analiza datelor, măsurarea calității, gestionarea programelor, tehnologia informației medicale, managementul utilizării serviciilor, gestionarea îngrijirii și programe de wellness. Telligen sprijină, de asemenea, inițiative naționale și interstatale de îmbunătățire a calității, axate pe rezultate mai bune în domeniul sănătății și pe gestionarea sănătății populației.

Contracts and Compliance Manager

Lead contract oversight and compliance for Telligen’s Medicaid Tailored Care Pathways program. The role covers HFS requirements, audits, reporting, corrective actions, and operational procedures.

Descriere

  • Lead contracting and compliance for Telligen’s Tailored Care Pathways program.
  • Advise program teams as a subject matter expert.
  • Act as the primary contact for company contracting activities.
  • Ensure TCMP services are delivered, documented, and reported in line with HFS policies and the requirements of the Williams and Colbert Consent Decrees.
  • Create, implement, and maintain compliance policies, procedures, processes, and practices.
  • Translate contract terms, policies, and program guidance into operational procedures and compliance activities.
  • Review program activity and documentation 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 reports, documentation, and contract deliverables.
  • Track updates to HFS policies, contract requirements, and program guidance, and coordinate internal changes.
  • Assist with internal and external audits, monitoring, and compliance reviews.
  • Identify compliance risks and process improvements, and recommend corrective or preventive measures.
  • Follow compliance issues and corrective actions through resolution.
  • Educate and guide staff on contract requirements, policies, procedures, and compliance expectations.
  • Coordinate with internal stakeholders to support consistent TCMP implementation.
  • Carry out other assigned contract and program compliance duties.

Cerințe

  • 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 is required.
  • At least one year of experience leading or managing staff in compliance or contracting.
  • Ability to interpret contracts, policies, regulations, and program guidance and turn 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 work effectively with program, operations, quality, and leadership teams.
  • Ability to travel overnight 5% to 10% of the time.
  • Knowledge of applicable OMB policies and Federal Acquisition Regulations is preferred.
  • NCMA certification is preferred.
  • Telligen does not sponsor work authorization; applicants who require sponsorship now or in the future cannot be considered.

Beneficii

  • Employee-owned company where employees share in its success.
  • Benefits and other compensation are outlined in Telligen’s Benefits Summary.
  • Equal opportunity employer.
  • Reasonable accommodations are available during the employment process.

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