PricewaterhouseCoopers

Managed Care Compliance - Manager

PricewaterhouseCoopers

Charlotte, NC, USA
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Are you a detail-oriented professional with a passion for healthcare compliance? Are you looking for a challenging and rewarding role in a fast-paced environment? PricewaterhouseCoopers is seeking a highly skilled and experienced individual to join our team as a Managed Care Compliance Manager. In this role, you will play a critical part in ensuring compliance with managed care regulations and guidelines, while also providing strategic guidance to our clients. If you have a strong understanding of healthcare compliance and regulations, excellent communication skills, and a proven track record of managing complex projects, we encourage you to apply for this exciting opportunity. Join us and make a difference in the ever-evolving world of healthcare compliance.

  1. Conduct research and stay updated on all relevant managed care regulations and guidelines.
  2. Develop and implement compliance strategies for managed care clients.
  3. Conduct audits and risk assessments to identify potential compliance issues.
  4. Provide guidance and training to clients and team members on managed care compliance best practices.
  5. Monitor and analyze changes in regulations and advise clients on necessary adjustments to their compliance programs.
  6. Collaborate with internal teams to ensure compliance with company policies and procedures.
  7. Create and maintain compliance reports and documentation.
  8. Act as a liaison between clients and regulatory agencies.
  9. Investigate and resolve any compliance violations or issues.
  10. Develop and maintain relationships with key stakeholders and industry experts.
  11. Assist in the development and implementation of compliance training programs.
  12. Stay informed of industry trends and developments to anticipate potential compliance risks.
  13. Lead and manage complex compliance projects.
  14. Communicate effectively with clients and internal teams to ensure timely and accurate completion of compliance tasks.
  15. Provide guidance and support to junior team members.
  16. Identify opportunities for process improvement and implement solutions.
  17. Collaborate with cross-functional teams to develop and implement company-wide compliance initiatives.
  18. Maintain confidentiality and handle sensitive information with discretion.
  19. Adhere to all ethical and professional standards set by the company and regulatory agencies.
  20. Continuously evaluate and improve the company's compliance program.
Where is this job?
This job is located at Charlotte, NC, USA
Job Qualifications
  • Bachelor's Or Master's Degree In Healthcare Administration, Business Administration, Or A Related Field.

  • Minimum Of 5 Years Experience In Healthcare Compliance, Preferably In A Managed Care Setting.

  • Strong Understanding Of Federal And State Laws And Regulations Related To Managed Care, Such As Hipaa, Affordable Care Act, And Medicare/Medicaid.

  • Experience In Developing And Implementing Compliance Policies And Procedures, As Well As Conducting Compliance Audits And Investigations.

  • Excellent Communication And Interpersonal Skills, With The Ability To Effectively Collaborate With Various Teams And Stakeholders, Including Senior Leadership.

Required Skills
  • Risk Management

  • Quality Assurance

  • Project Management

  • Data Analysis

  • Performance monitoring

  • Regulatory compliance

  • Policy Development

  • Contract review

  • Audit Oversight

  • Training And Education

  • Stakeholder Collaboration

Soft Skills
  • Communication

  • Conflict Resolution

  • Emotional Intelligence

  • Leadership

  • Time management

  • creativity

  • Critical thinking

  • Teamwork

  • Adaptability

  • Problem-Solving

Compensation

According to JobzMall, the average salary range for a Managed Care Compliance - Manager in Charlotte, NC, USA is between $91,000 - $140,000 per year. However, this can vary depending on factors such as experience, education, and the specific company and industry the individual is working in. It is important to research and compare salaries for similar positions in the same geographic location to get a more accurate understanding of the average salary range.

Additional Information
PricewaterhouseCoopers is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedMay 16th, 2024
Apply BeforeJune 9th, 2026
This job posting is from a verified source. 
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About PricewaterhouseCoopers

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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