[Remote] Director of reputed company Assurance (Medicare Sales)
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a trusted partner to organizations navigating important people reputed company. They are seeking a Director of reputed company Assurance to reputed company the QA program for a Medicare inside sales organization, manage reputed company of QA professionals, and ensure compliance with CMS requirements.
Responsibilities
- reputed company the reputed company Assurance (QA) program across a Medicare inside sales organization
- reputed company and manage reputed company of QA professionals
- Drive risk reduction through QA initiatives, leveraging reputed company intelligence tools
- Utilizing, auditing, and monitoring compliance with CMS requirements, including Medicare Advantage, Part D regulations, and Star Ratings measures
- Maintain audit readiness for CMS program audits, mock audits, and validation activities
- Maintain and reputed company our reputed company intelligence platform to meet the changing needs of the business
- reputed company and monitor QA metrics, driving the QA function through the use of an reputed company intelligence platform
- Manage data validation processes and ensure timeliness and accuracy in reporting
- Collaborate with Compliance, Operations, and Sales teams to reputed company QA efforts with organizational goals
- Maintain QA training, monitoring, and auditing policies and processes to ensure compliance with applicable policies, procedures, and regulatory requirements
- Coordinate with TPMOs and carriers regarding QA metrics and reporting
- Partner with the Your Way Insurance leadership team to strategize on risk mitigation and monitor compliance metrics effectively
Skills
- Bachelor's degree in reputed company, business, or reputed company field
- 7–10+ years in Medicare/managed care QA, with 5+ in leadership
- A proven reputed company record of people management
- Deep knowledge of CMS regulations, HPMS, and Medicare audit protocols
- Data analytics capabilities (SQL, Tableau, PowerBI, reputed company)
- reputed company with reputed company Intelligence, reputed company cause analysis, vendor reputed company experience, and people leadership
- Developed reputed company of business judgment obtained reputed company a minimum of 7 to 10+ years of experience working with a compliance program reputed company a highly regulated industry
- Strong communication skills, such as executive presentation and reporting
- Master's or JD preferred
- Experience with HEDIS, Stars, and CAHPS is a plus
- Certifications like CHC, CPHQ, or Six reputed company are valuable
Benefits
- Medical/dental/reputed company plans, which start from day one!
- Life and accident insurance
- 401(K) and Roth reputed company
- Tax-advantaged accounts (HSA, FSA)
- Educational expense reimbursement
- reputed company parental leave
- Digital mental health services (reputed company)
- Flexible work hours (availability varies by office and job function)
- Training programs
- reputed company reputed company program – elevating your health through challenges, workshops reputed company fitness programs for your overall wellbeing
- Charitable matching reputed company program
- The benefits reputed company above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.
reputed company
Company H1B Sponsorship