Director of Care Management Compliance

Job Summary

Managing delegated Care Management requirements, the full-time Director of Care Management Compliance will oversee audit execution, client inquiries, and compliance risk management while working remotely.

Key responsibilities

• Deliver a playbook for Client and Regulatory audit presentation readiness and execution
• Ensure prompt responses to client inquiries regarding Care Management topics
• Develop and execute customized monitoring programs to ensure compliance with key CMD requirements

Required qualifications

• 8+ years in a healthcare compliance role or related field within the healthcare industry, preferably with Medicaid experience
• Familiarity with Medicare Managed Care Coordination of Care regulations and NCQA standards