Senior Analyst Reg Compliance

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

Southfield, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

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Competitive Compensation and Benefits Package

Overview: <p><strong>SUMMARY:</strong>&nbsp;&nbsp;&nbsp;</p> <p>Regulatory Oversight Senior Analysts are responsible for leading and/or supporting processes that ensure oversight and ongoing monitoring of Blue Cross Blue Shield of Michigan (BCBSM) Medicare Advantage and Part D programs.&nbsp;&nbsp; Interface with external customers, including regulatory agencies and professional associations, internal customers and vendors to identify and/or analyze business problems and develop solutions is required.&nbsp;</p>
Responsibilities: <br /> <ul> <li>Ability to navigate and effectively interpret regulations and rules in accordance with the CMS Manual System and BCBSA guidelines.</li> <li>Develop and improve work flows and business processes within process area(s) to improve controls and overall quality.</li> <li>Assist with implementing and reviewing standard policies and procedures to ensure compliance with CMS regulations.</li> <li>Research, analyze, and disseminate CMS guidance and communications to MA internal and external stakeholders</li> <li>Identify, analyze, and track compliance risks and deficiencies.</li> <li>Review corrective action plans to ensure remediation leads to effective, compliant resolution.</li> <li>Review evidence submitted by vendors (FDR) to determine compliance with Medicare regulations.</li> <li>Participate in development and implementation of new procedures/controls.</li> <li>Provide recommendations for ongoing improvement of core processes.</li> <li>Assists personnel (both internal and external) by answering questions, supplying information, and training, as appropriate.</li> <li>Assists in the development, coordination, and implementation of methods and procedures to ensure that all sales, marketing, promotion, and operational documents and activities are compliant with CMS deadlines and regulations.</li> <li>Writes, revises, and maintains documents related to the sale and marketing of Medicare Advantage products and submit the materials for approval through the CMS, within the mandated deadlines.</li> <li>Facilitates CMS review of materials through research and investigation of the questions raised by and requests made by CMS.</li> <li>Develop and maintain an effective working relationship with customers.</li> </ul> <p><em>This position description identifies the responsibilities and tasks typically associated with the performance of the position.&nbsp; Other relevant essential functions may be required.</em></p>
Requirements: <p><strong>EDUCATION:</strong></p> <p>Bachelor&rsquo;s degree in a related field.&nbsp; Relevant combination of education and experience may be considered in lieu of degree.&nbsp; Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.</p> <p><strong>EXPERIENCE:</strong></p> <p>Three years of experience in a related field.</p> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Excellent analytical, organizational, problem solving, and verbal and written communication skills.</li> <li>Ability to work independently, within a team environment, and with multiple priorities/deadlines.</li> <li>Significant creativity and flexibility.</li> <li>Ability to contribute to process improvement projects.</li> <li>Ability to work and communicate with regulatory bodies and professional associations.</li> <li>Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word).</li> <li>Ability to develop, implement, and monitor policies and procedures.</li> </ul> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting with no unusual hazards.&nbsp;</p> <p>The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.&nbsp;</p> <p><em>We are an Equal Opportunity Employer.&nbsp; Diversity is valued and we will not toler</em></p>