Senior Medicare Compliance Consultant

Primary City/State:

Arizona, Arizona

Department Name:

Compliance-Corp

Work Shift:

Day

Job Category:

Compliance

Primary Location Salary Range:

$36.41 – $60.69 / hour, based on education & experience

In accordance with State Pay Transparency Rules.

You have a place in the health care industry. At Banner Health, caring for people is at the core of all we do. We are committed to diversity, equity and inclusion. If that sounds like something you want to be a part of – apply today!

Becker’s Healthcare recently honored Banner as one of 150 top places to work in health care for 2024, we are proud to offer our team members many career and lifestyle choices throughout our network of facilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.

The schedule for this role is 5/8’s, 8:00 AM – 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight is in place for accurate, complete, and compliant activities. This team highly values experience with:

Monitoring internal operational control measures ensuring appropriate oversight is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D.

Identifying and documenting all noncompliance related activities and reports accordingly in a timely fashion.

Working in start-up environment

Medicare Advantage Compliance training, audits, regulations, and manuals.

Reviewing Policy and Procedures

Ensuring reporting requirements are maintained in a timely and accurate fashion, including the resolution of each case/issue identified and closed.

Participating in the preparation of presentation materials designed specifically to communicate and promote the understanding of compliance.

Overseeing the thorough documentation of all compliance and noncompliance related activities.

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits.

This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WV, WA, WI & WY.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, youll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position coordinates Banner’s Compliance Program and its related policies, procedures, processes and activities. Based on area of assigned responsibility, assists in actively managing compliance-related matters by region, business area or facility. Such matters include assisting compliance personnel throughout Banner, helping develop and distribute compliance documents, providing compliance training and education, conducting compliance investigations and reports, monitoring and auditing activities, responding to allegations of improper or illegal activities, and investigating and remediating identified systemic problems.

CORE FUNCTIONS

1. Manages highly complex and sensitive questions, concerns and complaints related to compliance matters, providing answers and support to system, divisional, regional and facility leadership. Ensures that reasonable steps are taken to respond timely and appropriately to compliance issues and concerns.

2. In consultation with others in the Compliance and Legal Departments, manages Banner’s response to governmental or other third-party audits, investigations or inquiries. Works with system-wide groups and committees to develop policies or processes to address identified issues.

3. Supports the system, division, regional or facility compliance management staff by responding to questions or concerns, researching matters of note, providing training as necessary and developing processes and procedures to remediate concerns or issues.

4. Stays knowledgeable on current compliance-related laws and regulations through personal initiative, seminars, training programs and peer contact.

5. This position interacts with a multitude of executive and senior management, physicians and staff throughout Banner depending on the facility, division or area that is being reviewed or assisted. The diversity of areas is significant, ranging from Banner executives to operational management and staff, to executives and managers with external partners or companies, clinical departments such as pharmacy to the accounting treatment of specific transactions. The position will be required to work cooperatively with various external agencies and auditors.

MINIMUM QUALIFICATIONS

Must possess a strong knowledge of business and/or health care compliance as normally obtained through the completion of a bachelor’s degree in business administration, accounting/finance, or health care related field. Must also possess five plus years of current and progressive experience in healthcare compliance or an equivalent combination of relevant education and experience.

Requires knowledge of laws and regulations pertaining to health care, regulatory compliance, Medicare/Medicaid and/or financial reimbursement systems.

Must possess strong planning skills and problem solving skills. Must possess strong oral and written communication skills to effectively interact with senior management team, physicians and federal and state governing bodies. Must also possess highly effective negotiation skills to communicate and interact with senior management team and physicians.

PREFERRED QUALIFICATIONS

Masters degree and/or professional designations preferred. Previous payer, health care or academic compliance experience preferred as relevant.

Additional related education and/or experience preferred.

Anticipated Closing Window (actual close date may be sooner):

2025-02-01

EEO Statement:

EEO/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)

EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability