Health Care

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VP of Compliance – ChicagoUnique opportunity to be part of a team that builds a NEW business unit.  Working closing with the business unit CEO, this individual will ensure regulatory compliance with state Medicare, Medicaid program and state health care cost containment activities for the state health plan.  Develop and maintain records of Medicare and Medicaid contracts, contract amendments, compliance measures and improvements, policy, procedure and process documentation.  Develop policies, procedures and processes to comply with state law, federal law and state contract requirements.  Train health plan staff of new policies, procedures and processes. Oversee the Billing Errors, Abuse and Fraud program at the health plan level. Serve as the primary local contact for BEAF reports and liaison with the Corporate Special Investigations Unit (SIU).   Balance reporting requirements to multiple constituencies including. Oversee the health plan privacy program.  Chair, participate in, attend, and plan/coordinate, staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars. Serve on Senior Executive and management committees, as well as direct special projects or studies.  Investigate areas of non-compliance and initiate corrective action where necessary.  EXPERTISE REQUIRED Requires a Bachelor’s degree in Public Policy, Government Affairs, Business Administration or equivalent. At least 5 years of relevant experience. Extensive knowledge of state administrative code and regulations, Medicare, Medicaid and state insurance laws and regulations including managed care regulations. Experience with state and federal government agencies, accreditation bodies, participating provider agreements, HIPAA and Third Party Administration (TPA) laws, credentialing regulations and prompt pay laws. Master’s or Law degree preferred. ABOUT THE COMPANY:Our client is one of America’s premiere managed medicaid companies.  You’ll enjoy a comprehensive benefits program, very competitive salary OUR FIRM:Health Career Professionals, LLC is a health care staffing and recruiting company who provides professional services to health care workers and companies.  Our clients are national and regional health care plans who seek the services clinical and operational professionals in contract, interim, and permanent positions.*By applying to this position you are agreeing to receive additional information from our firm and our periodic email newsletter about new opportunities and career information.  Your personal information is NEVER released to any third parties.