Description
Providence caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. As a Providence caregiver, you’ll apply your specialized training to deliver world-class health with human connection and make a difference every day through your extraordinary care.
Providence is calling a Compliance Manager: Sales who will:
Responsible for implementation, monitoring, education and adherence of the 7 required elements of Providence Health Plan's Compliance Program and Center for Medicare and Medicaid Services (CMS) regulations with respect to all consumer sales lines of business activities
This position will report to the Director of Sales Enablement and be accountable for overseeing the day-to-day compliance initiatives for all sales channels
Serves as subject matter expert enabling consumer sales to meet compliance requirements applicable to Medicare, sales and marketing materials, agent training, reporting and sales complaint management
Works in partnership with the consumer compliance team providing guidance and support to internal departments, including marketing, customer service and other teams to ensure consumer sales practices are in compliance with Medicare guidance
Responsible for Medicare Advantage, Medicare Supplement and Individual lines as it pertains to sales and marketing activities
We welcome 100% remote work for residents who live in the States of Oregon, Washington & California.
Essential Job Duties and Responsibilities
Develop and assist with the delivery of comprehensive Medicare compliance training to staff, agents, and other stakeholders
Assist in the company's overall compliance program, including risk assessments, audits, and monitoring activities
Develop a continuous improvement program to identify compliance issues within consumer sales while ensuring sales tools and processes are compliant with federal and state regulations, especially CMS
Develop, implement, and manage Medicare sales compliance policies and procedures are current and in alignment with CMS regulations and guidance.
Monitor changes to CMS regulations and guidance, updating policies, procedures, and training materials as needed
Strong interpersonal skills, with ability to establish and maintain effective relationships with PHP management and other internal stakeholders to promote compliance as a valuable risk-management service with process improvement benefits to the organization
Strong understanding of health care laws, rules, regulations, and industry best practices with ability to effectively convey and interpret complex information to a variety of audiences
Oversight of complaint investigations within all sales distribution channels to ensure proper tracking, resolutions and corrective actions are taken as needed
Perform other duties as assigned
Required qualifications for this position include:
Bachelor's Degree in Business Administration, Economics, Healthcare Administration, or other related field of study -OR- a combination of equivalent education and experience
5+ years' experience health insurance industry in sales, marketing, compliance, legal or product roles, preferably in Medicare and/or Individual lines
5+ years experience in relevant health plan, compliance, and/or legal -OR- in another regulated industry
5+ years experience with two of the following areas: Process improvement; policy and procedure development, technical or legal writing, written customer communications, sales, or product management
Preferred qualifications for this position include:
3+ years' experience in a Health Plan's Regulatory Compliance, Risk Management, Legal or Government Affairs department
In-depth knowledge of CMS regulations and guidance pertaining to Medicare Advantage, Prescription Drug Plans, and other Medicare products
Demonstrated ability to summarize complex, technical materials and make clear presentations of that information to varied audiences.
Demonstrated ability to effectively communicate regulatory requirements to management and staff personnel.
Demonstrated ability to effectively evaluate fiscal, operational, sales, marketing and regulatory information and develop sound recommendations to meet related opportunities and challenges.
Demonstrated ability to successfully manage multiple tasks, shifting priorities and externally imposed deadlines.
Demonstrated ability to work supportively and effectively with regulators.
Demonstrated project management skills, including planning, implementation, and team motivation.
Demonstrated skills to lead staff.
Solid skills with standard word processing, spreadsheet, and data-base software.
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.
We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.
We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.
Requsition ID: 183294
Company: Providence Jobs
Job Category: Compliance
Job Function: Legal/Compliance/Risk
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 SALES MEDICARE AND INDIVIDUAL OR REGION
Address: OR Portland 4400 NE Halsey St
Pay Range: $43.39 - $70.03
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.