Deputy General Manager/General Manager - Compliance - Healthcare Domain (16-25 yrs)

An esteemed client of Inquest Consulting, BPM service provider in the healthcare domain, is seeking compliance in the US healthcare sector to in Bangalore and ready to work in Shift Timings: 02.00 PM- 11.00 PM and as necessary

Job Responsibilities include:

1. Manage a comprehensive healthcare compliance strategy aligned with the company's growth objectives and risk tolerance, with a deep understanding of the healthcare regulatory landscape of the United States.

2. Provide oversight of the risk-assessment process, ensuring the process is effective, collaborative, and includes the voice of the customer, regardless of location.

3. Recognize and address the interconnection of compliance risks between the lines of business, regions, affiliates, and systems and ensure the compliance risks are prioritized and integrated into risk plan development.

5. The GM of Global Compliance is responsible for ongoing compliance monitoring within the purview of the Sagility Code of Conduct, and its policies, procedures and client obligations.

6. Enable, and develop a global compliance team to successfully lead periodic compliance audits in coordination with the audit department, operations, and other cross-functional teams in multiple global locations.

7. Lead and manage the compliance teams within each operational geography and collaboratively work with multiple compliance personnel to enforce compliance related laws, regulations, contractual requirements, procedures, audits and other initiatives relevant to company's and its clients.

8. Conduct regular assessments to identify compliance risks and vulnerabilities; develop and implement solutions to such risks and vulnerabilities; and audit and monitor solutions to risks and vulnerabilities post-implementation.

9. Stay updated with evolving best practices, and governmental requirements relevant to all services delivery locations; interpret and communicate compliance requirements to stakeholders across the organization utilizing multiple communication channels.

10. Maintain compliance documents and up-to-date compliance reports and records as required and necessary.

Skills required:

- Candidates with 15+ yrs of experience with US health care is mandatory.

- Relevant compliance related certifications would be an added advantage such as Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Chief Privacy and Compliance Officer (CPCO).

- Extensive knowledge of healthcare compliance laws, regulations, and standards applicable to healthcare BPO companies operating in the commercial, Medicare and Medicaid space, including those addressing anti-corruption and anti-bribery, privacy, ARRA, HITECH, HIT-1, Prior Authorization, HIPAA and Healthcare Assessments, Medicare and Medicaid audits and assessments, URAC, NCQA accreditation in Utilization Management, Population Health Management, Health Plan and Medical Centered Medical Homes for example.

- Proven track record of developing and implementing successful compliance strategies in alignment with CMS, OIG and ISO problem-solving and decision-making abilities.

- Good understanding of technology and operating systems within the healthcare industry for claims processing and backend office functions.

- Legal background with an excellent understanding of the healthcare regulations and laws of the US and of all operational locations.