4Insurance Jobs

This job ad has been posted over 60 days ago...

0

applicants

About our Company
Independence Blue Cross is a company in motion, continually refining our processes and products to offer the best value to our more than 3.5 million members. As a pacesetter in our dynamic industry, Independence Blue Cross is not only a leader, but also an experienced innovator growing and expanding into new markets in ways that logically maximize our opportunities and success.

Job Summary

Responsibilities
Manages the day to day Medicare Compliance program and work plan.
Responsible for the audits and day to day management of the Medicare Advantage and Part D monitoring and audit function and supervision of staff.
Responsible for working with the leadership of the operational departments to ensure corrective action plans are in place.
Review the implementation of new or changed regulatory requirements and procedures and review the adequacy of controls and facilitate ad hoc audits to validate, as necessary.
Communicate and interact with management across the organization.
Deliver operational guidance, assistance and instructions.
Perform risk assessment of the business.
Provide development, coaching and leadership support for monitoring and staff.
Maintains all organization and professional ethical standards.
Provides guidance to departmental leadership to institute resolutions to issues and then monitor the outcome once the resolution is in place in conjunction with other departments.
Ability to establish and maintain relationships of trust with government personnel on sensitive compliance issues.
Proven ability to establish and maintain relationships of trust with senior management and departmental management.
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.
Responsible for the coordination and for ensuring the ongoing occurrence of the Medicare Compliance Committee.
Must be highly organized, able to handle multiple assignments with overlapping deadlines.
Must have the ability to show attention to detail.

Required Qualifications
Bachelor's degree or equivalent experience required , Masters degree preferred.
Comprehensive knowledge of Medicare Advantage and Medicare Prescription Drug Programs operations and regulations is strongly preferred. Proficiency in the use of Microsoft Office (Word, Excel, and Access) required. Strong analytical skills required. Excellent communication skills (written and verbal) required.
8 or more years experience in managed care or insurance industry required. Previous Medicare Advantage or Part D experience preferred .

Equal Employment Opportunity
Independence Blue Cross is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, disability, or veteran status.

Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross Family of Companies employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of the Independence Blue Cross Family of Companies . Please note that no fee will be paid in the event the candidate is hired by the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.

How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://independencebluecross.contacthr.com/20396468

« Go back to homepage
Is this job ad fake? Report it!   
Recommend to a friend

Published on Jul 07, 2011
Viewed: 323 times