STAR+PLUS COMPLIANCE MANAGER

JOB SUMMARY:
The Manager, Compliance - STAR+PLUS will be responsible for the daily management and oversight of the HHSC STAR+PLUS program to ensure compliance with applicable laws, regulations, and contractual requirements. Specifically, this position will require in-depth knowledge of STAR+PLUS including developing and establishing policies and procedures to comply with this Medicaid managed care program for adults with complex medical needs. This position will be responsible for providing leadership, guidance, and education company-wide to ensure compliance/accuracy with policies, procedures, and deliverables related to STAR+PLUS. Strong collaboration, communication, and interpersonal skills are required.

JOB SPECIFICATIONS AND CORE COMPETENCIES:

• Compliance lead for developing, implementing, and evaluating company-wide effectiveness of STAR+PLUS program related functions
• Develop, implement, and manage Compliance policies and procedures for STAR+PLUS and collaborate with the Policies and Procedures team to ensure accuracy of regulatory requirements and citations. Timely and accurately communicate compliance-related information to operational areas, Director, and Chief Compliance Officer.
• Develop training material and conduct internal / external stakeholder training sessions as necessary.
• Collaborate with internal operational areas on matters related to regulatory reporting, audits, and corrective action plans related to STAR+PLUS.
• Marginal Functions
• Analyze and evaluate information related to the healthcare regulatory environment by monitoring appropriate state, federal and industry channels, and participating in workgroups as applicable. Monitor and assess compliance risks with state and federal regulations related to STAR+PLUS and develop strategies to mitigate risks.

MINIMUM QUALIFICATIONS:

• Education/Specialized Training/Licensure: Bachelors degree in healthcare administration, business administration or related field required. Masters degree in business or healthcare related field preferred.
• Work Experience (Years and Area): 5-7 years of experience in healthcare compliance, with a focus on the STAR+PLUS program and managed care required. Experience working with regulatory agencies preferred.

Management Experience (Years and Area): Minimum of 2 years of management, supervisory experience, leading projects and conducting training required.

Software Proficiencies: Standard Office Equipment