ABOUT USJoin us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health, and connecting members with community-based resources

POSITION SUMMARY

Providing compliance assistance under general supervision of the Compliance Officer with technical support to administer the contract with the Centers for Medicare and Medicaid Services (CMS) and the health plan. This position requires assistance with the identification, development, and maintenance of the health plan’s required standards to support the CMS contract for effective health care compliance across the organization. Providing directions and service to interna customers with regards to ongoing compliance functions. Assisting the Compliance Officer with the implementation of the Compliance Program Requirements across the organization.

ESSENTIAL FUNCTIONS

• Develops and maintains compliance monitoring and reporting information related to compliance objectives and regulatory changes that govern the contract between the health plan and CMS
• Works in collaboration with health plan staff to compile and maintain information reports and dashboards for compliance effectiveness and controls
• Provides support for compliance risk assessments and audit plan (internal/external) customers
• Assists in providing input on and tracking of status of policies related to compliance initiatives, interdepartmental needs, regulatory changes, and interdepartmental requirements
• Reviews and tracks administration of CMS HPMS Memorandum and plan response
• Assist with preparations of information to be communicated to health plan leadership
• Provides review and recommendation for remediation of compliance issues/concerns
• Prepares reports for review by the Compliance Officer for distribution to health plan staff and leadership
• Monitors CMS and AHCA updates as it relates to the administration of the health contract with CMS
• Assist Compliance Officer in anticipation of CMS audits

EDUCATION AND EXPERIENCE

· Minimum three (3) years of experience working with manage care plan and The Centers for Medicare and Medicaid (CMS)

· Experience must include being able to review and interpret Federal Regulations and CMS guidance and updates (on going)

· Knowledge of Medicare health care operations and health plan functions, marketing, enrollment data, claims data, etc.

· Working in a Compliance and or Oversight Capacity at the plan level

· Must be familiar with CMS Regulations and CMS Plan Guidance (CMS Chapters that govern plan administration) and internal audit function a plus

· Product Development and CMS Filings that accompany applications for expansions, new applications

· PC proficiency with Windows based software; MS Office Suite products with proficiency in Access, MS Project.

· Excellent verbal and written communication skills.

· Technological proficiency

· Ethical Conduct

· Strategic-Critical Thinking

· Thoroughness/ Thoughtfulness

· Time Management skills

EEO STATEMENT In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace. Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Job Type: Full-time

Pay: From $1.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Miami, FL 33166: Reliably commute or planning to relocate before starting work (Required)

Experience:

• FDA regulations: 1 year (Preferred)

Work Location: One location

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