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| Compliance Liaison HI Open (J#45641) Title: Compliance Liaison Company: WellCare Health Plans Inc. Job Description The Compliance Liaison shall be responsible for assisting the Chief Compliance Officer to implement and monitor the policies, procedures, and practices designed to ensure compliance with the requirements set forth in the Corporate Integrity Agreement (CIA) and applicable Plan contracts with Medicare, Medicaid, and Federal health care program requirements and will serve as a contact person for the Chief Compliance Officer for compliance activities at the applicable Plans/Markets. They are also a local liaison for the various Corporate Compliance departments including Audit and Monitoring, Investigations, Information Security and HIPAA, Records Information Management, and Policies & Training. - Assist the Chief Compliance Officer to implement the policies, procedures, and practices designed to ensure compliance with the requirements set forth in the CIA and the Plan's contracts with Medicare, Medicaid, and Federal health care program requirements for the applicable Plan - Assist the Chief Compliance Officer to monitor the day-to-day compliance activities at the applicable Plan - Serve as a contact person for the Chief Compliance Officer for compliance activities at the applicable Plan. The Compliance Liaisons shall make periodic (at least semi-annual) written reports regarding compliance matters directly to the Chief Compliance Officer. - Provide assistance and operational oversight of external audits including: risk assessment, external audit management, preparation and facilitation - Local CAP/IAP Oversight - Provide escalation path within the market for compliance related issues. Pull in the appropriate resources and support from Corporate Compliance as needed. - Monitoring and oversight of vendors as needed to ensure compliance - Work as a liaison with the Compliance Special Investigation teams, including conducting investigations relative to agent Sales & Marketing and enrollment FWA cases and conducting interviews with potential beneficiaries, members, agents, providers, associates and/or downstream entities as required for investigatory purposes. - Conduct and track on-site compliance trainings and updates to the field organization - Local subject matter expert for HIPAA and responsible for local oversight of HIPAA requirements - Local contact for the Records Information Management department. Assist in training and oversight as needed. - Serves as the local internal information security consultant to the organization, documenting and implementing security policies and procedures in consultation with the Chief Privacy officer and Chief Compliance Officer. - Monitors compliance with Information Security policies and procedures, referring problems to the appropriate department manager, data owner, HR, legal, IT or other as necessary. - Assist Regulatory Affairs in monitoring state regulatory register and flagging new rules. - Assist Regulatory Affairs in reporting as needed - Assist Regulatory Affairs with projects at the local level as needed. - Other projects and duties as assigned. More... | |||
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