Compliance Manager

🕒 July 22

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $77.8k - $124.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Magellan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 $101M Private Equity Round on 2004-01

Consulting • Insurance • Healthcare

Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.

📋 Description

• Serve as the compliance and privacy manager for assigned company areas or strategic business units • Assist with regulatory and contract compliance for Care Center-managed or corporate-supported business • Implement or support SBU and/or Corporate Compliance Programs • Manage HIPAA compliance, including audits and preparation for state and customer audits • Develop and annually update written compliance programs for assigned Care Management Centers when applicable • Educate staff about compliance and compliance program details • Direct federal and state regulatory and compliance activities • Customize corporate policies to address state regulatory standards and contractual requirements • Liaise with customers on legal and regulatory issues • Chair local compliance committee meetings when applicable • Coordinate with Internal Audit and the Special Investigations Unit on fraud, waste, and abuse auditing and monitoring • Ensure corrective actions are implemented for known compliance deficiencies • Submit reports to QIC, Compliance Committee, Business Unit Manager, and Corporate Compliance Department • Maintain expertise regarding authorization and non-authorization correspondence requirements under ERISA, NCQA, URAC, federal regulations, and state law • Assist in reviewing standard correspondence and coordinate policy and IT system changes • Attend customer meetings to report on compliance matters when applicable • Serve as central contact for internal and external customers regarding assigned compliance, security, HIPAA, and anti-fraud efforts • Assist with internal and external audits and compliance-status reporting • Oversee Care Center-delegated entities and their compliance activities when applicable • Ensure delegated-entity compliance data is reported to the QIC

🎯 Requirements

• Knowledge of HIPAA, federal and state regulatory processes • Medicare Advantage and/or Medicaid managed care experience preferred but not required • Strong interpersonal, organizational, and project management skills • Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups and organizations into a written product • Excellent verbal and written communication skills • 5-8 years compliance related experience • Experience and thorough understanding of Microsoft Office, flow charting, and other relevant software systems and applications • A combination of education and work experience may be considered • Bachelor's degree listed as required education • Must reside in Louisiana • Must comply with applicable legal, regulatory, contractual, and internal policy requirements • Must understand, comply with, and attest to position-specific security responsibilities and controls

🏖️ Benefits

• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary, and other benefits and perks • Tobacco-free workplace