Medicare Compliance Lead - Accenture

Accenture seeks an individual with a deep understanding and working knowledge of Medicare Advantage (MA) laws, regulations and Centers for Medicare and Medicaid Services (CMS) guidance to lead Accenture's Medicare compliance program and initiatives. The Medicare Compliance Lead will need to: + Have a deep working knowledge of the requirements of MA laws, regulations and CMS guidance. + Lead Accenture's efforts to operationalize MA compliance requirements in Accenture's business, and implement necessary controls, policies and procedures. + Track and monitor changes in MA laws, regulations and CMS guidance, manage regulatory tracking software, and work with operational area(s) to perform business impact assessment(s), identify changes to current procedures and work with Medicare Compliance Officer to implement policies and policy changes needed to maintain compliance with Medicare/regulatory requirements. + Monitor CMS regulatory and compliance initiatives relating to Medicare. + Serve as Medicare subject matter expert aiding the operational leads/areas with the interpretation and execution of CMS rules, regulations and/or guidelines. Answer questions from business, compliance and legal regarding MA requirements. + Review, oversee and monitor client account teams' implementation of Accenture's Medicare Operations Compliance Plan (MOCP). + Maintain the MOCP and develop, review, implement and oversee the effective administration of policies and procedures, in partnership with key stakeholders, to facilitate Medicare and regulatory compliance. + Perform periodic and "on demand" compliance reviews and audits to identify opportunities and monitor compliance. + Assist in responding to client audits where Medicare expertise is needed. + Assist in preparing responses to Medicare compliance and offshoring attestations. + Assist legal in reviewing and revising Medicare contract flowdown terms. + Develop, maintain, and deliver Medicare compliance training programs. Monitor and track compliance with required Medicare training programs. + Conduct audits and evaluate internal and downstream entity workflows to assess compliance with Medicare rules, regulations, and guidelines. + Compile evidence and documentation that demonstrate Medicare/Regulatory requirements have been met. + Proactively identify risks, gaps, and deficiencies and/or business efficiency opportunities through ongoing, monitoring activities. + Initiate, develop, or support corrective action plans identified through audits or by recommendation of client; follow through on corrective action plans until operational areas meets standards and/or requirements. + Monitor key Medicare-related transaction turn-around times to assess operational risk. + Evaluate policies and procedures with corresponding desk level procedures to ensure regulatory and CMS requirements are addressed, operational activities compliant and reporting/success measurement evidence requirements met. Basic Qualifications: + Minimum of 3 years in a managed care organization servicing a Medicare population + Minimum of 3 years working in compliance performing Medicare oversight and training activities including monitoring of CMS regulations and Medicare compliance plan development/maintenance Preferred Qualifications: + BA/BS + Excellent client and customer service skills, and excellent written and verbal communication skills required. + Proven ability to work collaboratively with diverse individuals and situations required. + Potential need to travel internationally to the Philippines, India and/or other international locations. + Demonstrated teamwork and collaboration in a professional setting + Medicare Compliance and CMS audit experience + CHC certification preferred + Project management experience + Strong written and verbal communication skills + Strong quantitative, qualitative, and analytical skills or any combination of education and experience, which would provide an equivalent background + Experience using excel and other data collection or reporting software is preferred Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Maryland, New York or Washington as set forth below. We accept applications on an on-going basis and there is no fixed deadline to apply. Information on benefits is here. (https://www.accenture.com/us-en/careers/local/total-rewards) Role Location Annual Salary Range California $131,100 to $338,300 Colorado $131,100 to $292,200 District of Columbia $139,600 to $311,200 New York $121,400 to $338,300 Maryland $121,400 to $270,600 Washington $139,600 to $311,200 What We Believe We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment. Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities. Read more here (https://www.accenture.com/us-en/about/inclusion-diversity/us-workforce) Equal Employment Opportunity Statement Accenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law. Accenture is committed to providing veteran employment opportunities to our service men and women. For details, view a copy of the Accenture Equal Employment Opportunity and Affirmative Action Policy Statement (https://www.accenture.com/content/dam/accenture/final/accenture-com/document/Annual-Policy-Statement-Regarding-EEO-2023-Applicant.pdf#zoom=50) . Requesting An Accommodation Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired. If you would like to be considered for employment opportunities with Accenture and have accommodation needs for a disability or religious observance, please call us toll free at 1 (877) 889-9009, send us an email (https://www.accenture.com/us-en/about/contact-us) or speak with your recruiter. Other Employment Statements Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States. Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration. Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.