Medicare Compliance Officer

Develops, operates and administers the regulatory compliance program for both Medicare Advantage (Part C) and Medicare Part-D plan activities for Mercy Care Plan. Mercy Care Plan is managed by Schaller Anderson, an Aetna Company. Reports directly to the Plan CEO and the Audit and Compliance Committee of the Board of Directors of SCHN.

• Develops and monitors the implementation of and compliance with Medicare policies and procedures through the creation and implementation of a work plan.
• Reports, at least on a quarterly basis, or more frequently as necessary, to the board of directors, president and/or CEO, and compliance committee, on the status of Mercy Care Plan's Medicare compliance program implementation, the identification and resolution of potential or actual instances of noncompliance, and the Plan's oversight and audit activities.
• Creates and coordinates, or appropriately delegates, educational training programs to ensure that the Plan's officers, directors, managers, employees, and other individuals working on the Medicare program are knowledgeable of Mercy Care Plan's compliance program; its written standards of conduct,
• policies, and procedures; and the applicable statutory, regulatory, and other requirements.
• Ensures that first tier entities, downstream entities, and related entities, particularly those involved in sales and marketing activities, are aware of and follow the requirements for Medicare sales and marketing activities.
• Briefs the compliance committee and governing body on the status of compliance training.

Required

• Bachelors Other or an equivalent combination of directly related workexperience and/or education and Five (5) years of experience thatdemonstrates solid Medicare complianceprogram development, operation andadministration responsibilities, upon hire and

Preferred

• Registered Nurse: AZ, upon hire

Hello humankindness

Located conveniently in the heart of Phoenix, Arizona,St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved. We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s. U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children's Hospital. St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. Look for us on Facebookand follow us on Twitter. For the health of our community ... we are proud to be a tobacco-free campus.