Managed Care Compliance - Manager
Are you a detail-oriented individual with a passion for healthcare and compliance? Do you have experience in managed care and a strong understanding of regulatory requirements? If so, PricewaterhouseCoopers is seeking a dynamic and driven individual to join our team as a Managed Care Compliance Manager. In this role, you will be responsible for overseeing and ensuring compliance with all aspects of managed care contracts and regulations. We are looking for someone who is highly organized, possesses excellent communication skills, and has a strong background in healthcare compliance. If you are ready to take on a challenging and rewarding role, we would love to hear from you.
- Oversee and ensure compliance with managed care contracts and regulatory requirements.
- Develop and implement compliance policies and procedures.
- Conduct audits and reviews to ensure adherence to regulatory standards.
- Stay up-to-date with changes in healthcare laws and regulations relevant to managed care.
- Train and educate staff on compliance requirements.
- Communicate regularly with internal and external stakeholders to address compliance concerns and provide updates.
- Identify and mitigate potential compliance risks.
- Collaborate with cross-functional teams to develop and implement compliance strategies.
- Monitor and report on compliance metrics and trends.
- Investigate and resolve compliance issues and complaints.
- Maintain accurate and organized records of compliance activities.
- Ensure timely and accurate completion of compliance-related tasks and reports.
- Participate in industry conferences and seminars to stay current on best practices.
- Continuously seek opportunities to improve and streamline compliance processes.
- Serve as a subject matter expert on managed care compliance for the organization.
In-Depth Understanding Of Managed Care Regulations And Compliance Requirements: The Ideal Candidate For This Role Should Possess A Strong Understanding Of Federal And State Regulations Related To Managed Care, As Well As Industry Best Practices For Compliance.
Experience In Developing And Implementing Compliance Programs: The Candidate Should Have Previous Experience In Designing And Implementing Compliance Programs For Managed Care Organizations, Including Policies, Procedures, And Training Programs.
Knowledge Of Healthcare Industry Trends: The Managed Care Landscape Is Constantly Evolving, And The Candidate Should Be Well-Versed In The Latest Industry Trends, Such As Value-Based Care And Alternative Payment Models.
Strong Analytical And Problem-Solving Skills: As A Managed Care Compliance Manager, The Candidate Will Be Responsible For Identifying And Resolving Compliance Issues. Therefore, Strong Analytical And Problem-Solving Skills Are Essential For This Role.
Excellent Communication And Leadership Abilities: The Candidate Should Have Excellent Communication Skills And The Ability To Lead And Collaborate With Cross-Functional Teams. This Role Will Involve Working With Various Stakeholders, Including Clients, Internal Teams, And Regulatory Agencies, So Effective Communication Is Crucial.
Communication Skills
Project Management
Data Analysis
Team Leadership
Risk assessment
Audit management
Policy Development
Contract review
Regulatory Knowledge
Process
Training And Education
Compliance Analysis
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Time management
creativity
Networking
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Managed Care Compliance - Manager in San Francisco, CA, USA is approximately $120,000 - $180,000 per year. However, this range can vary depending on factors such as experience, education, and specific job responsibilities.
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PricewaterhouseCoopers is a multinational professional services network with headquarters in London, United Kingdom. PwC ranks as the second largest professional services firm in the world and is one of the Big Four auditors, along with Deloitte, EY and KPMG.
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