**Overview**

Under general direction, the Compliance Manager is responsible for operating and improving NASCO’s Government Services Compliance Programs through the development, implementation, oversight and monitoring of compliance program activities. This role is responsible for researching, analyzing, understanding and communicating federal regulatory impacts to the organization and its Plan customers. This role coordinates with the Security Team to ensure compliance with the HIPAA Administrative Simplification Regulations (45 CFR 160, 162, 164). This role supports the Privacy Office with tracking of all reported potential privacy incidents from intake of the initial report through investigation to resolution with the applicable Plan customers. The position's duties include collaborating and interacting with matrixed groups in a multi-functional environment to assist operations, functional groups and NASCO’s Plan customers in meeting and adhering to applicable federal legal and regulatory requirements and contractual obligations. This position communicates with multiple internal departments, Plan customers, and others as necessary to complete work and communicates with the Director of Government Programs regarding status of projects and assignments.

**Responsibilities**

Leads and manages NASCO’s Compliance Tracking Program for Medicare Advantage and Exchange regulations and provides guidance in support of/with the Plan customers

• Continuously monitors multiple sources to stay updated on relevant regulatory changes and other regulatory developments, maintaining documentation to track and communicate impact analyses to the organization and Plan customers

• Supports product teams by identifying regulatory requirements that require changes to our product capabilities and operational units with development and/or improvement of processes designed to ensure compliance with applicable legal and regulatory requirements

• Facilitates regulatory review conference calls with Plan compliance representatives and internal cross functional teams, sharing regulatory analysis and documenting decisions on changes business processes and systems required by regulatory requirements

• Maintains documentation to track analysis, impact and decisions related to operational, governance or product changes required by Government regulatory changes

• Provides substantive, subject-matter support to the Director of Government Programs

• Manages the NASCO annual training process and the annual policy review process, serving as a subject matter expert for MetricStream and providing support to the Policy Committee, when needed

• Provides support in managing Compliance Committee quarterly meetings

• Manages and updates the Compliance work plan, providing weekly status updates to compliance leadership

• Supports the Privacy Office in handling reports of potential privacy incidents from notification to closure

+ Serves as an active member on various external and internal organizational committees related to implementation of processes that ensure compliance with applicable legal and regulatory requirements

• Provides vendor compliance management oversight for privacy and federal government program compliance

+ Location: State of Texas

**Qualifications**

+ Advanced ability to analyze and evaluate legal and regulatory requirements applicable to healthcare and insurance industries

+ Intermediate knowledge of regulatory and legislative processes

+ Intermediate knowledge of Code of Federal Regulations (CFRs), HPMS memos, FAR / FEHBAR requirements, HIPAA Privacy and HIPAA Security

+ Demonstrated advanced attention to detail

+ Advanced communication skills, including verbal, written, and technical writing skills. Able to communicate appropriately across all levels of an organization.

+ Effective problem-solving skills

+ Advanced skills in building partnerships with staff, customers, and vendors

+ Advanced ability to work independently, be self-motivated, and a self-starter

+ Intermediate ability to develop, foster, and maintain customer relationships at all levels of an organization

**Experience:**

+ 5 years of managed care compliance experience such as Medicare Advantage/Healthcare Exchanges/Medicaid/FEP

+ 5 years of experience working with health plan claims, enrollment and delivery processes

+ 5 years of healthcare industry experience

+ 2 years - Policy and procedure development experience

+ 4 years of program management knowledge, experience and skills

**Required Training, Certification and Education:**

Bachelor's degree, or equivalent experience

**Preferred Training, Certification and Education:**

+ Certifications:

+ Certified in Healthcare Compliance (CHC)

+ Certified in Healthcare Privacy Compliance (CHPC)

+ PMI Certification

+ Master's degree in a related field

**Benefits Overview**

At NASCO, we trust our workforce to be fully remote, **_working from their home_** . This benefit offers significant, personalized outcomes for each associate including work/life balance, savings on commuting, work clothing, and increased time to spend on personal activities.

Our full benefit package is designed to support the physical, mental, and financial health of our associates. We offer:

**Physical and Mental Health Benefits**

+ Choice of Blue Cross Blue Shield Medical, Dental, and Vision Plans

+ Telehealthcare – for Medical and Behavioral visits

+ Generous PTO with buy/sell options

+ 9 Company holidays, a floating day off, and a day off for volunteering

+ Employee Assistance Program

+ Wellness program - earn insurance discounts or credit towards health-related items

**Financial Health Benefits**

+ 401K Plan with employer matching contributions

+ Company-funded spending/reimbursement accounts to help with out-of-pocket medical expenses

+ Bonus and Recognition programs

+ Tuition Assistance

+ Consultation with financial planner

+ Basic Life & AD&D Insurance, Short and Long-Term Disability Insurance provided, and Supplemental Term Life Insurance is available

+ Group Discount programs - mobile, technology services, etc., to help you save money

**Other Benefits**

+ E-Learning – Comprehensive and current library of e-learning and performance support assets, available on demand and at no cost

NASCO is an Equal Opportunity Employer/veterans/disability/race/color/religion/sex/sexual orientation/gender identity/national origin. Must have legal authority to work in the US.

_We will not accept applicants that use AI when answering the screening questions. Applicants who use AI to answer any questions or to complete their application will not be considered for employment._

**Location** _US-Home Office/ Remote_

**\# Positions** _1_

**Category** _Other - Other_

**Travel Requirements** _0-20%_