Senior Corporate Compliance Analyst
Company: MetroPlus Health Plan
Posted on: May 12, 2022
Empower. Unite. Care. MetroPlusHealth is committed to empowering
New Yorkers by uniting communities through care. We believe that
Health care is a right, not a privilege. If you have compassion and
a collaborative spirit, work with us. You can come to work being
proud of what you do every day.
About NYC Health + Hospitals MetroPlus Health Plan provides the
highest quality healthcare services to residents of Bronx,
Brooklyn, Manhattan, Queens and Staten Island through a
comprehensive list of products, including, but not limited to, New
York State Medicaid Managed Care, Medicare, Child Health Plus,
Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
As a wholly-owned subsidiary of NYC Health + Hospitals, the largest
public health system in the United States, MetroPlus' network
includes over 27,000 primary care providers, specialists and
participating clinics. For more than 30 years, MetroPlus has been
committed to building strong relationships with its members and
providers to enable New Yorkers to live their healthiest life.
The Senior Corporate Compliance Analyst reports to the Director of
Corporate Compliance and Privacy. The Senior Corporate Compliance
Specialist will support the oversight and management of Corporate
Compliance activities, including assisting in the review of
department policies, investigating reports of non-compliance,
addressing and tracking inquires, responding to all corporate
compliance related questions, monitoring and auditing business
areas, supporting the organization with corrective actions and
contributing to the annual compliance risk analysis and work plan.
- Ensuring the Corporate Compliance related trainings are accurate
and up to date.
Job Description Assist the Director of Corporate Compliance and
Privacy in the development of the annual risk assessment and
implementation of the annual work plan.
Manage ongoing monitoring activities and develop and execute audits
as identified in the annual compliance work plan.
Responsible for the initial screening, timely investigation, and
triaging of compliance matters. Ensuring a thorough and
comprehensive investigation of the alleged compliance violation is
performed, including data gathering, analyses, interviews, and
issuing a final report. Essential to this role is the ability to
track and trend emerging issues and work with the Director to
develop a respond on an organizational level for systemic
Respond to questions and concerns relating to general corporate
compliance matters, including exclusion screening, fraud, waste and
abuse concerns, institutional gift policy, etc. with internal
Develop, issue, and monitor corrective action plans as issues arise
from ongoing monitoring and auditing activities. Must be able to
track, trend and escalate matters as needed.
Creating, reviewing, and submitting internal and external reports
as required. Will need to engage with leadership from various areas
and vendors to compile information needed for response. Includes
data submitted for the various committees in which Corporate
Compliance participates, including the Fraud, Waste and Abuse
Committee, Compliance Committee, and Audit and Compliance Committee
of the Board of Directors.
Assist in managing our relationship with the Special Investigations
Unit, including: active participation in monthly meetings, ensuring
ongoing collaboration, and identifying opportunities for
Monitoring ongoing exclusion screening processes. Ensuring all
responsible business units are conducting the necessary screenings
on a monthly basis.
Responsible for ensuring P&Ps related to Corporate Compliance
are reviewed and updated on an annual basis and as regulatory
Conduct an annual assessment of our corporate compliance
Must remain abreast of emerging topics and issues impacting
corporate compliance on the State and Federal level. If any changes
impact the organization, must be able to work across departments to
ensure proper implementation.
Support the Director of Corporate Compliance and Privacy with any
required regulatory reporting.
Other duties as assigned or requested
Minimum Qualifications A Bachelor's degree required.
5 or more years of Managed Care experience.
3-5 years' experience in a compliance, privacy, regulatory affairs,
or government affairs function within a Managed Care Organization,
Strong knowledge of the requirements and processes on agencies such
as DOH and OMIG
Prior successful experience working with regulators on compliance
audits, reporting and other matters.
Experience managing complicated projects, keeping track of details,
and staging work to deliver projects on time.
Proven ability to articulate regulatory requirements to business
and technical staff to capture information and achieve results.
Experience with developing reporting and metric.
Solid Microsoft Excel skills and strong proficiency using MS Word,
PowerPoint, and SharePoint.
Broad-based in-depth knowledge of the managed care industry,
including: strategic compliance planning, regulatory concerns,
compliance requirements, and corporate integrity principles.
Knowing the processes and requirements of regulators (DOH, OMIG,
The ability to comprehend and interpret regulatory, legislative,
and contractual mandates.
Experience working with regulators on compliance audits, reporting
and other matters.
Experience with managed care, Medicaid and federal regulations,
quality improvement and compliance oversight.
High-level of skill in leading interdepartmental and
cross-functional projects; experience managing professional staff
on multiple projects to ensure corporate deadlines and objectives
Excellent oral, written, and presentation skills, state as well as
conceptual and analytic skills are necessary to review and
articulate corporate objectives and Federal regulations across all
The utmost integrity in the discreet and confidential handling of
confidential materials is necessary.
Keywords: MetroPlus Health Plan, Paterson , Senior Corporate Compliance Analyst, Professions , Chester, New Jersey
Didn't find what you're looking for? Search again!