General Purpose: The individual holding this position is required to support and demonstrate their commitment to the Longevity Health Statement of Purpose, which is: To improve the health and quality of life of nursing home residents by caring for their unique medical, social and emotional needs.

The Senior Medicare Compliance Specialist is responsible for assisting and supporting the Compliance Department of Longevity Health.

 

Key Tasks and Responsibilities:

• Develop, prepare, and present reports of factual observations, findings and recommendations designed to improve compliance.
• Facilitate corporate level committee calls, including the preparation and distribution of committee materials.
• Development, review, and oversight of mandatory CMS marketing materials.
• Independently prepare and facilitate routine meetings with internal business partners.
• Assist in the development, performance, and maintenance of policies, standards, and procedures.
• Coordinate and assist in preparation of responses to CMS inquiries.
• Support and participate in health plan auditing and monitoring activities, internally and externally.
• Develops and maintains various compliance logs to track compliance activities, such as internal compliance matters, HIPAA breach incidents, external inquiries, compliance audit plan, etc.  Summarizes and prepares reports for various audiences.
• Develop and prepare reports of compliance program activities, including collection of data, methodology of actions performed, implementation of action plans, and reporting findings. Also be able to speak to activities in meetings with various levels of staff.                     
• Monitor CMS and Federal regulatory updates and create a summary report on any changes.
• Responds to the needs of the health plan and the department by performing other duties as assigned.
• Performs other related duties as assigned.

 

Licensure:

• There are no licensure requirements for this position.
• Auto liability insurance coverage per minimum required by home state.

 

Education and Training:

• Bachelor’s degree preferred or equivalent work experience.

 

Knowledge and Experience:

• Strong computer skills with willingness to learn new systems.  Advanced competence in Word, Excel, and PowerPoint required.
• Knowledge of CMS guidance, HIPAA, and other applicable healthcare regulations.
• Three-Five years’ experience in a compliance department; preferably in managed care
• Ability to work independently and organize workload.
• Demonstrated accuracy, dependability, and orientation to detail.
• Excellent interpersonal, written, and verbal communication skills.
• Able to problem solve and deal with problems involving several variables in standard situations.
• Able to work flexible hours.

 

Company Overview:

Founded in 2018, Longevity Health started as an Institutional Special Needs Plan (ISNP), a type of Medicare Advantage health plan that addresses significant unmet needs of long-term institutionalized members who reside in nursing homes.  Through rapid growth from 2018 to 2022, we expanded our market footprint and currently offer ISNP Medicare Advantage plans in Colorado, Florida, Illinois, Michigan, New Jersey, New York, and North Carolina. 

In 2023, we expanded our service offerings to the broader health plan market.  In addition to our existing markets where we are both the ISNP and the care management team, we are now partnering with National Carriers on their offered ISNP plans in Ohio, Pennsylvania, upstate New York, Georgia, South Carolina, and Texas, with implementations in progress for several other additional US states. This allows us to utilize our core skills of supporting clinical post-acute needs of this vulnerable senior population Currently 13 markets and expanding rapidly.

 

Company Disclaimers:

Longevity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

It is the policy of Longevity Health to follow Federal and / or State regulations surrounding COVID vaccinations.  While CMS guidelines have been relaxed, there are some LHP facilities which will still require staff be vaccinated in an effort to protect the health of the members / patients we serve.  If your assigned location(s) require all staff to be fully vaccinated, you are required to obtain and / or provide documentation related to your COVID vaccination.  To confirm whether your assigned location(s) require COVID vaccinations, please refer to the Facility Guide Job Aid located on Longevity Health Plan’s intranet site. 

 

The Company will engage in an interactive process with individuals who cannot be vaccinated for medical or sincerely held religious beliefs to determine if a reasonable accommodation can be made. While an exemption/accommodation may be initially granted, if at any time during employment, it is determined that an exemption/accommodation that has been granted is no longer considered a reasonable accommodation, it can result in employment with the Company ending.

 

Candidates must meet the Company’s hiring criteria which include a pre-employment background and drug screening.

 

Longevity Health offers a competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).

 

Submission of false information during the application process may result in immediate termination of employment without notice.