What are the responsibilities and job description for the Healthcare Compliance Consultant position at LanceSoft, Inc.?
Job Description
- The resource will work three days a week at the client location until fully trained, and thereafter, depending on their progression, they will then work once a week onsite.
- The Business Analyst Sr. is responsible for leading and/or supporting processes that ensure oversight and ongoing monitoring of Client's Medicare Advantage and Part D programs.
- The primary duties of this role encompasses overseeing sales and enrollment processes to ensure compliance with Client regulations for Medicare Advantage operations.
- Additionally, the position involves enhancing workflows and business processes to bolster controls, mitigate risk, and enhance overall quality and efficiency.
- Compliance Monitoring: Ensure agents comply with Client regulations and guidelines for selling and enrolling Medicare Advantage plans.
- Quality Assurance: Monitor and evaluate agent performance to ensure quality service and accurate information to potential beneficiaries.
- Policy Interpretation: Interpret and communicate Medicare policies and guidelines.
- Metric Tracking: Establish and track performance metrics to assess agent effectiveness and identify areas for improvement.
- Regulatory Updates: Stay informed about changes in Medicare policies and regulations to ensure agents remain compliant.
- Collaboration and Communication: Collaborate with cross-functional teams and communicate with stakeholders to ensure alignment and effectiveness in oversight.
- Process Improvement: Continuously identify and implement process improvements to enhance efficiency and effectiveness in oversight.
- Legal and Ethical Adherence: Ensure that agencies and agents adhere to legal and ethical standards in their interactions with beneficiaries.
- Risk Management: Identify and mitigate risks associated with agent activities to maintain compliance and protect the organization’s reputation.
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