Product Manager- Regulatory and Compliance

Infosys • Tempe, AZ

1d

About The Position

Infosys Helix is seeking a Product Manager- Regulatory and Compliance for this growing team. The Regulatory leader will provide leadership and oversight for the implementation and operations for Infosys Helix to ensure compliance with applicable regulations for Medicare advantage programs including CMS Audits for US health plans. This role will be the primary point of contact for the client for all aspects of compliance including regulatory updates, audits and quality and performance reporting.

Requirements

• The candidate must be located within commuting distance of Tempe, AZ or be willing to relocate to this area. This position may require travel in the US.
• Bachelor’s degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of Education.
• 7 Yrs of experience in Information Technology.
• Experience in regulatory compliance roles for US healthcare with deep expertise in Medicare Advantage programs.
• Experience in developing HIPAA compliant applications/ operational processes.
• Experience participating in CMS audits for Medicare advantage
• Experience working in cloud technologies and implementing controls for BPaaS scenarios
• Experience in compliance program administration including risk assessments, policy creation, training, monitoring and reporting, audits and investigations.
• Medicare related regulations, FDR oversight and audit requirements, HIPAA
• Strong understanding of healthcare payer operations.
• Excellent communication, presentation, and interpersonal skills
• Ability to influence cross functional teams without direct authority.
• Strong analytical and risk-based decision-making skills.

Nice To Haves

• Ability to elicit information from myriad of SMEs (technical & business).
• Ability to provide thought leadership and influence to implement strategic methods.
• Ability to switch between projects and maintain consistency.
• Ability to be a part of a diverse team/ multiple stakeholder environment.
• Working in an agile environment- with Scrum, Kanban, SAFe methodologies.
• Experience and desire to work in a Global delivery environment.

Responsibilities

• Serve as compliance partner for the client for the implementation and operation of Infosys Helix BPaaS services for Medicaid Advantage plans.
• Ensure that regulatory, contractual and other compliance requirements are translated into scalable, auditable operational controls embedded into applicable platform workflows and business processes for the client.
• Responsible for end-to-end management of compliance activities including compliance risk assessment, creation of policies, procedures and standards, training and awareness, monitoring and reporting, internal compliance audits and support for external audits, and incident management and notifications.
• Responsible for implementation of product capabilities required for Medicare Advantage compliance, including generation of audit universes, HEDIS and STAR reporting, monitoring frameworks.
• Periodic communication to Infosys Helix and client leadership on status of compliance program as well as applicable compliance risks.
• Responsible for regulatory research and implementation of regulatory updates across the platform and processes.

Benefits

• Medical/Dental/Vision/Life Insurance.
• Long-term/Short-term Disability.
• Health and Dependent Care Reimbursement Accounts.
• Insurance (Accident, Critical Illness, Hospital Indemnity, Legal).
• 401(k) plan and contributions dependent on salary level.
• Paid holidays plus Paid Time Off.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level