Compliance Manager

Compliance Manager (Insurance)

MarketSource Inc., an Allegis Group Company, develops and delivers innovative managed sales solutions for enterprise customers. MarketSource provides the unique skills and expertise to integrate brand-centric managed sales programs in the Automotive, Information Technology, Telecommunications, and Manufacturing industries in Business-to-Business (B2B) and Retail models.

Founded in 1975, MarketSource, Inc. became a subsidiary of Allegis Group, Inc. in 2004. Our Company’s culture centers on our core values: Open Communication, Relationships, Serving Others, and Work Ethic. MarketSource clients rely on the innovative managed sales solutions that our vertical-specific, subject matter experts develop and deliver. Our team members thrive in a welcoming atmosphere of diversity, inclusion, and exemplary corporate practices.

Summary

Responsible for leading a team and driving regulatory compliance and risk mitigation efforts through the organization, by identifying risk areas and prioritizing and establishing appropriate protocols. This role interacts with various company stakeholders and will assist in structuring processes, procedures, and technology to maximize our risk mitigation efforts.

Essential Job Functions

• Design, implement, and lead the insurance compliance management strategy for the organization’s Medicare Advantage sales program including carrier compliance, and multi-carrier
• Oversee the investigation and remediation of customer and CTM complaints, Medicare sales allegations, and grievances and lead deficiency identification and corrective action plan development
• Support the Executive team in embedding a culture of insurance compliance awareness
• Ensure compliance with regulatory obligations including Centers for Medicare and Medicaid Services (CMS), while applying a commercial and practical approach to risk-based solutions
• Ensure the organization’s insurance sales practices, training, and marketing comply with CMS and applicable regulations
• Establish systems and metrics to monitor the status of identified risk areas
• Develop, lead, and drive engagement of the Licensing and Compliance team to maximize effectiveness and ensure compliance with licensing, renewal, and continuing education requirements
• Establish various audits and procedures to ensure compliance with regulatory and contractual provisions as well as internal policies
• Develop processes, policies, and procedures in areas deemed as high risk/exposure to the organization
• Provide appropriate training and education to organizations around risk mitigation, insurance compliance, and best practices
• Inform Senior Management of best practices, regulatory, CMS, and legislative changes and their obligations under these changes
• Manage the successful delivery of compliance projects (audits, etc.) to the organization
• Partner with Financial Operations, Legal, Allegis Compliance/Risk Management, Human Resources, Technology Solutions, and Executive Leadership on all relevant areas of risk
  
  

Required Knowledge, Skills, And Abilities

• Strong leadership skills, communication skills, and work ethic
• Knowledge and experience commensurate with this role
• Practical and commercial approach to problem-solving
• Ability to evaluate and develop efficient and effective operational processes and policies
• Ability to assess performance and identify areas of improvement
• Strong business judgment and organizational agility
• Proven management, leadership, communication, problem-solving, and decision-making skills
  
  

Job Requirements

• Bachelor’s degree in business administration with an emphasis on risk management, actuarial science, communications, or similar field preferred
• Experience leading a multi-tiered risk organization
• CMS compliance experience required
• 10+ years of insurance/business/financial/audit/risk/contract management experience required