Corporate Compliance Manager : Port Huron, MI

• Location 2186 Water Street,Port Huron, MI, 48060,United States
• Base Pay $61,200.00 / Year
• Employee Type Full Time

Contact information

• Name HR
• Phone

Description

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

• 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

• Five years of experience supervising staff
• Five years of experience working in Corporate Compliance
• Experience with Microsoft Power Point
• Advanced knowledge of MDHHS PIHP/CMH reporting
• Advanced knowledge of State of Michigan Medicaid Provider Manual

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…