Job Details

A company is looking for a Clinical Compliance Program Manager.Key Responsibilities:Ensure compliance with CMS, NCQA, and other regulatory standards through performance measurement and outcomes activitiesAssist in the development and enforcement of policies aligned with Utilization Management and Compliance requirementsConduct compliance audits and prepare for regulatory, accreditation, and contractual auditsRequired Qualifications:At least 4-6 years of relevant work experienceAdvanced working knowledge of CMS UM audits with 2-3 years of compliance experience1-2 years of experience implementing CMS final rule changesBachelor's Degree or equivalent work experience