Job DescriptionThis position assists with the implementation of the Magellan Pharmacy Compliance Program.
- Assists with the implementation of the Magellan Rx Compliance Program, and educates the management team and staff about compliance and the appropriate components of the compliance program and the Office of Inspector General (OIG) Work Plan.
- Administers and customizes the tool utilized for the management of compliance issues.
- Tracks and manages compliance issues.
- Manages corrective action plans.
- Manages issues submitted to Compliance Mailbox and escalates to the Medicare Compliance Officer.
- Reviews CMS HPMS memos, and regulatory guidance and disperse to impacted operational areas and monitor to completion.
- Responsible for organizational compliance with HPMS notices, CMS and regulatory guidance, as appropriate.
- Interacts effectively with internal operations areas to provide guidance and information.
- Reviews operational policies and procedures to ensure compliance with CMS regulations and state and federal laws.
General Job Information
TitleMRx Compliance Manager
Job FamilyLegal Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date5/2/2019
Date Requisition Created5/1/2019
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- Requires 5+ years of compliance related experience.
- Strong interpersonal, organizational, and project management skills.
- Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups and organizations into a written product.
- Excellent verbal and written communication skills.
- Knowledge of Medicare regulations.
- Experience and thorough understanding of Microsoft Office, flow charting and other relevant software systems and applications.
- Experience working for a Managed Care Company or other health related organization strongly preferred.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
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