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Senior Compliance Professional
San Juan, PR Internal Number: R-345219 Senior Compliance Professional - Remote Job Summary: We are seeking a highly skilled Senior Compliance Professional to join our team and help ensure compliance with regulatory requirements for our Medicare and Commercial Dental and Vision products in Puerto Rico. This role will involve researching compliance issues, developing policies and procedures, coordinating with external regulators, and conducting compliance reviews. The ideal candidate will have a strong understanding of federal and state laws and regulations, as well as experience working in a legal, risk, or compliance-related field. Fluent proficiency in both English and Spanish is required for this role. This is a full-time, remote position with a salary range of $84,600 - $116,300 per year. Responsibilities: ● Research and make recommendations to ensure compliance with regulatory and contractual obligations for Medicare and Commercial Dental and Vision products in Puerto Rico ● Develop and implement regulatory compliance policies and procedures ● Coordinate engagement with external regulators and implement corrective action plans, if needed ● Provide compliance guidance and direction to business partners and conduct periodic compliance reviews ● Develop and monitor metrics to track compliance performance and identify potential risks ● Work with systems to track issues and corrective actions ● Analyze business requirements and provide regulatory guidance to business partners and compliance associates ● Serve as the subject matter expert for Medicare and Commercial Dental and Vision compliance issues in Puerto Rico ● Lead audit preparation and activity and serve as a subject matter expert for external audits ● Present findings of monitoring and auditing efforts to business partners and compliance leaders ● Provide back-up and support to other compliance team members and participate in committees Qualifications: ● Bachelor's degree in a related field ● Fluent proficiency in both English and Spanish ● Advanced experience in a legal, risk, or compliance-related or healthcare-related field ● Strong analytical skills and ability to understand the impact of regulatory requirements on business operations ● Ability to utilize data analytics to identify compliance risks ● Excellent communication skills and ability to present to leadership ● Strong attention to detail and focus on process and quality ● High level of emotional intelligence and ability to work independently with excellent judgment Preferred Qualifications: ● J.D. or other graduate degree ● Knowledge of CMS and/or various Departments of Insurance and other regulatory agencies ● Experience interacting with governmental agencies ● Experience with metrics, KPIs, and other data analytics Why work for us? At our company, we value our employees and strive to create a caring and inclusive community. We prioritize putting health first and offer a comprehensive benefits package, including a bonus incentive plan. Our hiring process is fair and inclusive, and we are proud to provide accommodations for those who may need them. Join our team and make a positive impact in the healthcare industry. Apply now! |
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