Responsible for ensuring compliance with Texas Health and Human Services Commission (HHSC) and Centers for Medicare and Medicaid Services (CMS) regulations and expectations, including creating and monitoring policies and reports (deliverables).  Assist in all Compliance Department duties related to the STAR+PLUS and Medicare lines of business.  Works closely with the Chief Compliance Officer and the Compliance Manager as well as interfacing with all other operational departments.

Required Skills

1. Strong verbal and written communication skill.
2. Excellent presentation skills, as well as conceptual and analytic skills in order to review and articulate company objectives and Federal regulations across all relevant audiences.
3. Highly detail orientated.
4. Ability to analyze and solve problems.
5. Ability to develop policies and procedures.
6. Ability to be a self-starter and follow through on projects with minimal management oversight. 
7. Ability to coordinate professional staff at all levels on multiple projects to ensure deadlines and objectives are met.
8. Ability to seek out new methods and principles to improve services.
9. Bilingual in English and Spanish preferred.

Required Experience

Work Experience Three years of experience in managed care government programs (Medicaid, CHIP, STAR+Plus, Medicare/Medicare Advantage), paralegal, or legal training, required, working with managing compliance with laws and regulations, writing policies and procedures, working with quality improvement and /or regulatory compliance.    Experience in STAR+Plus or Medicare/Medicare Advantage highly preferred. 

License/Registration/Certification None.

Education and Training Bachelor degree in Health Care or Business related fields required. 

1. Strong verbal and written communication skill.
2. Excellent presentation skills, as well as conceptual and analytic skills in order to review and articulate company objectives and Federal regulations across all relevant audiences.
3. Highly detail orientated.
4. Ability to analyze and solve problems.
5. Ability to develop policies and procedures.
6. Ability to be a self-starter and follow through on projects with minimal management oversight. 
7. Ability to coordinate professional staff at all levels on multiple projects to ensure deadlines and objectives are met.
8. Ability to seek out new methods and principles to improve services.
9. Bilingual in English and Spanish preferred.