Job Summary
A health insurance company has an open position for a Remote Senior Clinical Regulatory and Compliance Manager.
Core Responsibilities Include:
- Develop, implement, and monitor processes to manage clinical audits
- Partner with key stakeholders such as Legal, Regulatory, Compliance, Appeals and Grievances, Finance, and Pharmacy
- Give timely and effective responses to audit inquiries and requests
Skills and Requirements Include:
- Associate’s degree
- Relevant prior experience such as experience working at a managed care health plan or delegated vendor
- Experience with pharmacy benefits management
- Demonstrated professionalism and leadership skills along with ability to develop, direct, and support a team
- Healthcare regulatory compliance experience
- Excellent time and project management, communication, critical/creative thinking, and problem-solving skills
