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[Remote] Lead Compliance Specialist, Medicaid - Remote

Work from home Full-time role Hiring

Note: The job is a remote job and is open to candidates in USA. EmblemHealth is a healthcare company, and they are seeking a Lead Compliance Specialist for Medicaid. The role involves ensuring compliance with regulatory requirements, providing guidance to business areas, and managing projects related to compliance initiatives.

Responsibilities

  • Conduct regulatory research to address compliance inquiries
  • Provide regulatory guidance and support for business process improvement efforts
  • Communicate with business leadership regarding events, training, and processes related to regulatory compliance initiatives and/or memos
  • Conduct monitoring and auditing of assigned business areas
  • Ensure that business areas/ delegates understand and address all actionable memos or directives and upload proof of implementation to centralized Compliance Department repository
  • Update and maintain centralized Compliance Department repository records as necessary and appropriate
  • Support external audits or regulatory requests as needed
  • Provide business areas with regulatory guidance to address and mitigate performance or monitoring gaps while ensuring regulatory requirements are met
  • Support business areas in creating and updating P&Ps, trainings, reports, monitoring activities and any project related function to ensuring compliance with regulatory memos and audits by internal stakeholders, vendors, and delegates
  • Contribute to Compliance Department committee and subcommittee materials as needed

Skills

  • Bachelor's degree
  • 5 – 8+ years' work experience in regulatory healthcare operations compliance
  • Thorough knowledge of State and/or Federal programs operations and regulations
  • Proficiency in the use of Microsoft Office - Word, Excel, Access, PowerPoint, Outlook, Teams, etc
  • Strong organizing, prioritizing, analytical, and problem-solving skills; and outstanding attention to details
  • Proven ability to establish and maintain relationships of trust with departmental staff and management
  • Proven ability to coordinate and lead interdepartmental work teams and meet established goals
  • Must be goal oriented and able to meet tight deadlines while handling multiple priorities
  • Must be a team player and able to take direction from multiple sources
  • Proven ability to effectively manage multiple tasks/projects with competing priority levels/deadlines
  • Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience
  • Ability to arrange work schedule to meet deadlines from multiple sources and engage staff throughout EmblemHealth to assist in the completion of duties
  • Advanced degree (MPH, MHA, JD and/or MBA) and/or professional certification

Company Overview

  • EmblemHealth is an insurance and wellness company that offers health benefits to consumers, employers, and government purchasers. It was founded in 1937, and is headquartered in New York, New York, USA, with a workforce of 1001-5000 employees. Its website is http://www.emblemhealth.com.
  • Company H1B Sponsorship

  • EmblemHealth has a track record of offering H1B sponsorships, with 2 in 2024, 2 in 2023, 2 in 2021, 4 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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