Healthcare Compliance Consultant

Details of the offer

Job Description The resource will work three days a week at the client location until fully trained, and thereafter, depending on their progression, they will then work once a week onsite. The Business Analyst Sr. is responsible for leading and/or supporting processes that ensure oversight and ongoing monitoring of Client's Medicare Advantage and Part D programs. The primary duties of this role encompasses overseeing sales and enrollment processes to ensure compliance with Client regulations for Medicare Advantage operations. Additionally, the position involves enhancing workflows and business processes to bolster controls, mitigate risk, and enhance overall quality and efficiency.
Responsibilities: Compliance Monitoring: Ensure agents comply with Client regulations and guidelines for selling and enrolling Medicare Advantage plans. Quality Assurance: Monitor and evaluate agent performance to ensure quality service and accurate information to potential beneficiaries. Policy Interpretation: Interpret and communicate Medicare policies and guidelines. Metric Tracking: Establish and track performance metrics to assess agent effectiveness and identify areas for improvement. Regulatory Updates: Stay informed about changes in Medicare policies and regulations to ensure agents remain compliant. Collaboration and Communication: Collaborate with cross-functional teams and communicate with stakeholders to ensure alignment and effectiveness in oversight. Process Improvement: Continuously identify and implement process improvements to enhance efficiency and effectiveness in oversight. Legal and Ethical Adherence: Ensure that agencies and agents adhere to legal and ethical standards in their interactions with beneficiaries. Risk Management: Identify and mitigate risks associated with agent activities to maintain compliance and protect the organization's reputation.


Nominal Salary: To be agreed

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