Compliance Manager (Sr Specialist)
Location: Eden Prairie, Minnesota
Description: Cigna is at present recruited Compliance Manager (Sr Specialist) right now, this vacancy will be delegated in Minnesota. Further informations about this vacancy opportunity kindly see the descriptions. Job Description
Role Summary:
Responsible for ensuring behavioral health operations for CIGNA affiliate product offerings are in compliance with federal and state laws in assigned state territory. Diverse job functions include regulatory reporting; state certification/licensure renewals; state market conduct exams; responding to regulatory inquiries, etc. Partners and supports Legal & Public Affairs/R&SGA and CIGNA Behavioral Health leadership, management and staff.
Responsibilities:
Maintains robust knowledge and understanding of legislative and regulatory requirements and behavioral health systems, processes and workflows to ensure impacts of regulatory/legislative requirements are properly identified and communicated to impacted operational areas.
Triages and facilitates mitigation and/or remediation measures of all known and potential regulatory, legal and business risks by partnering with matrix business partners to ensure behavioral health operations are updated to comply with federal and state statutory and regulatory requirements.
Coordinates, and reviews for accuracy and integrity, behavioral health data submissions for various CIGNA affiliate regulatory filings required for assigned state territory.
Tracks, maintains and renews all CIGNA Behavioral Health state Utilization Review Agent and Third Party Administrator certifications for assigned state territory.
Researches and responds to regulatory inquiries and complaints submitted by state Departments of Insurance and/or other regulatory agencies pertaining to behavioral health issues.
Facilitates state market conduct exams and/or audits pertaining to behavioral health operations including, but not limited to disseminating data requests to impacted operational areas; compiling the data and reviewing it for accuracy; researching and submitting written responses to identified deficiencies; facilitating corrective action plans when necessary, etc.
Provides back-up support to CIGNA Behavioral Health Central HIPAA Unit including, but not limited to tracking, investigating, responding to, remediating and reporting privacy complaints and incidents; coordinating quarterly Information Protection & Data Security walk-thru audits including compiling, consolidating and reporting upon outcome findings to site managers; ensuring the processing of all HIPAA Member Rights requests; Maintaining and updating policies and procedures, etc.
Supports CIGNA Legal by researching and responding to subpoenas, litigation requests and attorney inquiries pertaining to behavioral health issues. Coordinates depositions of behavioral health expert witnesses when necessary. Collaborates with CIGNA Corporate Secretary Office in updating CIGNA Behavioral Healths Officers and Directors and securing updated biographical affidavits required for regulatory filings. Submits Notifications of Material Changes to state regulatory agencies pursuant to state requirements.
Collaborates with CIGNA Corporate Risk Management in maintaining and updating Fidelity bonds; General Liability bonds; and state surety bonds..Requirements
Qualifications:
Undergraduate degree
5+ years experience working in a healthcare, legal, government or insurance environment with experience in regulatory compliance.
Proficient in reading, interpreting and applying laws
Superior verbal/written communication and interpersonal skills required
Excellent abilities in analyzing and synthesizing complex information
Results oriented with ability and willingness to work in matrix environment
Makes good decisions based upon a mixture of analysis, wisdom, experience and judgment.
Knowledgeable about how the health care regulatory industry works and its culture;
Knows how to get things done through both formal and informal channels by taking the initiative and being proactive;
Understands the origin and reasoning behind key health care policies, practices and procedures.
Is good at problem-solving by bringing creative ideas of others to market;
Demonstrates good judgment about which creative ideas and suggestions will work;
Facilitates and manages the creative processes of others; Initiates brainstorming sessions;
Contemplates how potential ideas may play out in the market place and/or regulatory environment.
Provides current, direct, complete and actionable positive and corrective feedback to others;
Comfortable identifying regulatory, legal and/or business risks with matrix partners and facilitating the implementation of measures to mitigate and/or remediate such risks.
Excellent time management skills with ability to multi-task in deadline driven environment with competing priorities..
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If you were eligible to this vacancy, please deliver us your resume, with salary requirements and a resume to Cigna.
Interested on this vacancy, just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Sat, 11 Aug 2012 14:33:38 GMT
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