Regulatory Compliance Manager

Regulatory Compliance Manager

The position of Regulatory Compliance Manager for the Regional Segment Compliance Team is responsible for effectively managing and handling a variety of regulatory compliance operations as further set forth below for the operating units in the segment.

Reporting to the Regional Segment Compliance Officer, the Regulatory Compliance Manager : 1.) must effectively lead a team and collaborate with individuals with varied backgrounds, experiences and in different locations, 2.) is required to ensure that assigned compliance processes are completed timely and in accordance with enterprise requirements, 3.) must effectively communicate relevant new legislation and regulation to business partners in the segment, 4.) must effectively collaborate and support various enterprise project initiatives that directly relate to in-scope compliance work.

Provide compliance training, guidance and oversight on the Medicare Secondary Payer laws and regulations, particularly with respect to Medicare Section 111 Reporting, and assist with compliance functions within any of the following areas and responsibilities on behalf of the operating units in the Regional Compliance Segment, which may be adjusted from time to time :

• Consumer Complaints Regulatory Exams and Investigations (including Market Conduct)
• Regulator Inquiries / Communication Workers' Compensation Board / Bureau Compliance Issues
• Data Calls
• Fraud Training and Compliance
• Privacy
• Paper Management
• Development of Compliance Training, Procedures, and / or Best Practices Guidelines
• Legislation & Regulation Communication
• Other duties as assigned

Must be able to proficiently use Microsoft suite of products : Word; Excel; Outlook; Teams; SharePoint.

Knowledge of Westlaw, Lexis / Nexis, Walters Kluwer or similar subscription service preferred.

Must have strong analytical skills and exercise sound professional judgment.

Must be detail-oriented, accurate, organized, able to work under time constraints and be self-motivated.

Strong communication and interpersonal skills to effectively communicate with internal and external business partners to achieve desired results.

Ability to manage a team of people with varied backgrounds and experiences.

Ability to work with minimal supervision.

Occasional travel may be required.

Education and Credential Requirement

Bachelor's Degree required. Juris Doctor (or equivalent degree) preferred.

Professional designations preferred.

Experience in Medicare Secondary Payer compliance preferred.

7+ years commercial insurance experience

7+ years of compliance-related experience in one or more of the Key Functions / Duties referenced above.