Job Summary
This position is responsible for directing the Payment Integrity compliance program. This involves tracking legislative updates and managing state filings pertinent to managed care operations. The director acts as the key contact for regulatory bodies and directs a team focused on ensuring compliance with established platforms.
Responsibilities
- Oversee the Payment Integrity compliance program and its effectiveness.
- Monitor and analyze legislative changes affecting managed care operations.
- Ensure accurate and timely state filings related to compliance.
- Serve as the main liaison with regulatory agencies to maintain compliance standards.
- Lead and manage a team dedicated to platform compliance efforts.
Qualifications
- Bachelor’s degree in business administration or a related discipline.
- A minimum of 10 years of relevant experience in workers’ compensation, managed care, and medical bill review.
MedRisk provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
