Description:
Culture Highlights!
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Telework environment – work from where it's most convenient, home, office, etc.
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Flexible work model – flex time creating a work-life blend meeting outcomes of role and life events.
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Monday through Friday schedule.
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9 paid holidays, and 3 additional floating holidays (pro-rate applies).
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Volunteer in your community – 24 hours awarded annually.
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Professional Development – internal and external learning and development opportunities.
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Robust Total Rewards – Medical/Dental/Vision, Telehealth, Flex Spending, 401k Matching, Life insurance, LT/ST Disability, EAP, & Mileage Reimbursement.
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Eligible employer for Federal Public Service Loan Forgiveness Program.
Position Summary:
The Compliance Manager is responsible for overseeing the operational support duties of Lakeland Care, Inc’s (LCI) compliance program, risk management, and member records support elements. The Compliance Program includes Medicaid-related fraud, waste, financial abuse detection and mitigation, adherence to HIPAA regulations, conflict of interest disclosure and reporting, organizational audit functions, and civil rights oversight. Risk Management includes office location lease management, insurance coverage, vendor contract review, and Business Associate Agreement (BAA) review. Member Records includes safeguarding the integrity and privacy of member records, ensuring compliance with the release of member records, and managing employee access to external medical records systems. Position will have three direct reports.
Responsibilities & Competencies:
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Manage the conflict-of-interest process for all new and current LCI employees, and members of LCI’s Board of Directors.
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Facilitate and serve as main contact for matters related to vendor contract review, insurance renewals, office lease renewals, and BAA drafting and review.
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Manage the member record request process, external medical record access functions, and integrity of member records.
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Initiate research as regulatory issues arise; provide analysis to the Compliance Director.
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Assure appropriate and timely follow-up on all compliance-related reports, investigations, member records requests, and concerns reported to the Compliance and Organizational Risk Division.
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Oversee internal compliance audit functions and ensure organizational program integrity.
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Assist in the facilitation of the HIPAA security risk analysis; collaborate with other LCI leadership on opportunities for improvement.
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Stay apprised of changing regulatory conditions and technology developments for program impact and organizational improvements.
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Support the development and delivery of training LCI staff and external stakeholders regarding LCI’s compliance program, program integrity, HIPAA, member records, civil rights, and other compliance-related topics.
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Submit reports and follow-up to regulatory oversight agencies; oversee and maintain the confidentiality of internal program integrity investigations and employee interviews; ensure proper documentation and timely follow-up is completed.
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Chair LCI’s Program Integrity Compliance Committee (PICC) and establish a HIPAA Committee. Oversee all Compliance-related committee activities and work product(s).
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Chair LCI’s Civil Rights Compliance Review Committee and oversee the annual Civil Rights Compliance review; assist with preparation of Civil Rights Compliance Plan and Civil Rights Compliance Letter of Assurance and submit to regulatory agencies as needed.
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Assist in policy, procedure, best practice standards, guideline development, and implementation; ensure LCI’s compliance program, program integrity, HIPAA, and member records access are instilled in LCI policies, procedures, and internal protocols.
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Ensure performance standards are met and establish a formal means of accountability; give adequate direction, advise of job responsibilities, conduct regular performance appraisals, and support staff in advancing their career path.
Are you excited about this role but not sure if your work experiences align to the role or qualifications? We encourage you to apply anyway. At Lakeland Care, our values drive how we do our work and how we hire. We strive to build an inclusive, authentic workforce that embraces diversity and differences in strengths. So be sure to highlight your skill set and competencies you’re confident in!
Requirements:
- Bachelor’s degree in Business, Finance, Healthcare Administration, Healthcare Information Management, other related field, or equivalent combination of education and experience.
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Juris doctor (JD) strongly preferred.
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Minimum of two (2) years of experience in compliance management, healthcare administration, and/or health information services, or equivalent combination of experience and education.
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Expertise in compliance ethics, Medicaid fraud, waste, and financial abuse, HIPAA privacy and security, civil rights regulations required.
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Prior management experience preferred.
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Must have continuous improvement mindset and experience in effective change management.
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Must demonstrate proficiency in Microsoft Office (SharePoint, Word, Excel, PowerPoint, Outlook).
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Must have exceptional verbal and written communication skills.
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Current driver’s license, acceptable driving record and proof of adequate insurance required.
Acknowledgement:
This job posting describes the general nature and level of work performed by the individual assigned to this position and should not be interpreted as all inclusive and is subject to change by the employer as the needs of the employer and requirements of the position change.
APPLICATION DEADLINE DATE: Accepting through 7/4/2024; may be extended as needed. Resume required.
For questions on this role, please reach out to the Talent Acquisition Specialist at Becky.Vang@lakelandcareinc.com.
**COMPENSATION ON EXTERNAL SITES ARE NOT LISTED BY LAKELAND CARE. PLEASE INQUIRE DIRECTLY WITH HUMAN RESOURCES.**
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Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities. Currently we serve members in 22 counties and have 10 offices throughout the Central to North East region of Wisconsin.
Our Mission
Empowering individuals. Strengthening communities. Inspiring futures.
Our Vision
To create a world we all want to live in.
Our Core Values
Kindness – We believe kindness is always possible and that no compassionate act is ever wasted.
Inclusion – We believe that open hearts and open minds are the only path to a brighter future.
Trust – We believe that honesty is still in style and that promises still have power.
We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.