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Government Programs Regulatory Reporting Lead - Health Plan

Remote, SD
Apply NowCurrent Employees Apply Here
Commute links off-site

Job Details

Careers With Purpose

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: Remote SD (Central Time)
Location: Remote, SD
Address:
Shift: Varies
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $32.50 - $52.00

Department Details

This position can remote or in office. If remote some in-person attendance will be required for training, team meetings, or special projects. These on-site responsibilities will be scheduled in advance.

Job Summary

The Government Programs Regulatory Reporting Lead will serve as the subject matter expert for regulated reporting and audit readiness of the Government Program products, including Medicare Advantage, ACA, and Medicaid, to ensure we are meeting all State and Federal regulations and time frames, and in accordance with Sanford Health Plans policies. This includes, but is not limited to assisting with questions related to data submissions, internal validations, and other task as assigned. Manages reporting, auditing, and data exchange of the government programs – Medicare Advantage, ACA, and Medicaid, in support of business objectives. Works collaboratively with operational units to ensure the products are accurately defined, communicated and configured; all member communications are compliant and data exchanges and reports are accurate, timely and meet State and Federal requirements. Serves as the main point of contact for all reporting related questions, issues, and interpretation. Leads in the development, implementation, process improvement, and education of the government program products. Leads in ensuring certifications, quality reporting, member materials and website content, and regulatory and statutory standards and requirements are met. Carries out operational policies and procedures that support organizational improvements and comply with Federal and State requirements. Other special projects as assigned. Occasional travel required.

Qualifications

Bachelor's degree in health care, finance or a related field.

Minimum five years of relevant experience required. A background or experience in health care reimbursement or contract negotiations preferred.

Benefits

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0220555
Job Function: Health Plan
Featured: No

Apply NowCurrent Employees Apply Here

Equal Employment Opportunity

Sanford and its affiliate brands have consistently operated under the principle of equal treatment for all persons; all qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, gender, gender identity, age, sexual orientation, genetic information, marital status, disability, military or veteran status, in regard to public assistance or any other basis prohibited by applicable federal, state or local law.

SAFE: Sanford Accountability for Excellence

As caregivers, we commit to the safety of those we serve and each other by creating a psychologically safe environment where everyone is included and safe to learn, contribute and raise concerns without fear of negative consequences. When people come to us, they rely on us to keep them safe from harm, do all we can to heal them, and treat them with empathy and compassion – all while embracing our connection to each other. Safety is part of our culture and defines the care we provide, and how we deliver on our universal commitment to a higher level of service and exceptional care.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call (877) 673-0854 or send an email to hrhelp@sanfordhealth.org.

In compliance with federal law requiring employers to verify new employees' U.S. employment eligibility, Sanford participates in E-Verify. To learn more about your right to work: English Version or Spanish Version.

Important Notice

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If you have questions about the legitimacy of an employment offer from Sanford Health, contact hrhelp@sanfordhealth.org.