Government Programs Compliance Consultant

## Government Programs Compliance Consultant Apply locations:
NM
- Albuquerque:
IL
- Chicago:
TX
- Richardson time type:
Full time posted on:
Posted Todayjob requisition :
R0050977

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.# #
** Job Summary**### BASIC FUNCTION  This position is responsible for supporting evaluation of government programs (Medicare and Medicaid) regulations, guidance and contracts, assessing the risk that those items present with respect to HCSC government contracts. Supporting the compliance department oversight of the business  operational compliance with the requirements through multiple mechanisms such as review of reports, attendance at operational meetings, and targeted monitoring of areas of concern.

Assisting in identification of risks and issues of noncompliance, development of strategies to mitigate and remediation of those risks and issues and work with compliance and business personnel, all levels of HCSC management and governmental agencies in order to implement controls and processes and report on results

NOTE:

this role is HYBRID/FLEX and requires in-office visibility three days per week, working from home the other two days. Relocation is not available and sponsorship will NOT be extended either now or in the future ~###
** JOB REQUIREMENTS
*** Bachelor’s degree and 3 years experience in health plans, regulatory compliance or risk management
** OR
* * 6 years’ experience in health plans, regulatory compliance or risk management.
* Ability to communicate with and build relationships with internal business units and/or various external government agencies.
* Critical thinking, risk assessment and mitigation.
* Excellent verbal and written communication skills.
* Ability to work with minimal supervision.
* Organizational, analytical and decision-making skills.
* PC proficiency to include Workday, Word, PowerPoint and Excel.
** PREFERRED REQUIREMENTS
*** Government Programs Healthcare Compliance experience. Equivalent experience will be considered.
* Knowledge of Medicaid contracts and regulations, Medicare Advantage, Part D or other regulatory experience.
* Bachelor’s Degree or higher preferred.
* Government programs operational experience.**~ KEY FUNCTIONS ~
** Will identify, review, analyze and understand contractual and regulatory requirements.
Evaluate Government regulations, guidance and contracts, and identify specific risks that they present to HCSC government contracts.
Review Government Programs policies and procedures, workflows, training materials and other documentation for compliance with requirements.
Consult with the business and provide guidance as the business plans, implements and monitors its compliance with contractual and regulatory requirements.
Identify and follow up on compliance issues and track issues to resolution.
Provide accurate and complete documentation of reported information, risks, issues, status and results.
Work with the business to agree upon issues, root causes, remediation steps, deliverables, additional training and education, communications, internal controls, compliance reviews or modifications to processes and due dates.
Participate in issue resolution process which may include, as appropriate, but is not limited to:
* * identifying barriers to meeting due dates*
* * identifying actions or escalations needed to address barriers*
* * escalating failure to meet due dates*
* * escalating barriers appropriately*
* * recommending disciplinary actions or other appropriate means to hold business owners accountable for actions or lack of actions.
* Validate that business remediation activities successfully addressed agreed-upon root causes, deliverables and remediation steps.
Participate in remediation activities including: identification of root cause(s), identification and stratification of risks, development and implementation of recommendations for processes that would result in their mitigation.
Assist…