Advanced Search


Start New Search:

pharmacy operations manager
lvn lpn
licensed vocational nurse lvn
store manager in training
pharmacy operations
disease management
social science
pharmacy manager
licensed practical nurse lpn
cvs pharmacy
diversity inclusion
better health
early morning
social worker
managed care
public health

Manager, Qualiity, Compliance & FWA

Share Job
Suggest Revision
Benecard Services IncBonita Springs, FL
  • JOB SUMMARY: Under the direction of the Senior Director, the Manager, Quality, Compliance and FWA is responsible for ensuring the Benecard Companies meet and maintain ongoing compliance with all applicable Medicare and other federal and state regulatory requirements.
  • The Manager is responsible for the monitoring and oversight of all compliance and regulatory requirements.
  • ESSENTIAL DUTIES AND RESPONSIBILITIES:Interpret and disseminate information on regulatory matters.
  • Develop, review and modify compliance information in manuals, forms and/or contracts, as needed.
  • Responsible for the execution of an enterprise-wide sampling and monitoring plan including communicating CMS or other rules and regulations.
  • Review and oversee corrective action plans, as necessary.
  • Support a comprehensive Fraud, Waste and Abuse program that adheres to federal or state requirements.
  • Responsible for ongoing activities to detect, correct, report and prevent Fraud, Waste and Abuse in all areas of the companyOversight of the activities of delegated entities.
  • Accept issues from internal customers, understand the underlying root cause, review regulatory rules, conduct analysis of risks and make recommendations to the operational departments to ensure compliance with requirements.
  • Develop and annually review compliance policies and procedures to ensure consistency with governing statutes, regulations and other guidance.
  • Review and update policies as laws and regulations change.
  • Provide written and oral advice and guidance regarding compliance requirements that impact the company's products and business.
  • Act as an internal resource on matters related to vision and pharmacy rules.
  • Support overall enterprise-wide compliance and risk management strategy.
  • Maintain a comprehensive understanding of all new and existing regulatory requirements that impact vision and pharmacy operations.
  • Assist with the development and implementation of the annual auditing and monitoring work plans.
  • Identify regulatory metrics to track compliance.
  • Develop and maintain robust auditing and monitoring tools and standardized forms.
  • Assist in and make recommendations for identification of compliance and quality indicators and benchmarks.
  • Identify areas of potential compliance risk and collaborate with management to develop solutions for risk mitigation.
  • Participate in CMS, state or health plan related audits and reviews.
  • Develop and provide training and education programs for the organization.
  • Assist in the development of a variety of training tools and communication vehicles to reinforce compliance enterprise-wide.
  • Deliver training presentations and workshops as required or necessary.
  • Manage projects as assigned, including product development and national compliance initiatives.
  • Coordinate compliance information for presentation to the Compliance Committee, Board Compliance Committee or the Board of Directors, as necessary.
  • Perform other duties, as assigned.
  • INTERNAL/EXTERNAL RELATIONSHIPS: Interaction with all levels of the organization and certain external vendors.
  • SUPERVISORY RESPONSIBILITIES: YesQUALIFICATION REQUIREMENTS: To be successful, an individual must be able to perform each essential duty and responsibility satisfactorily.
  • The requirements listed below are representative of the knowledge, skill and/or ability preferred.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Education and/or Experience:BA/BSMinimum of 3 years' experience with Government programs a mustPrior experience in the vision, pharmaceutical, healthcare or managed care industryKnowledge of vision and/or pharmacy benefit programsExperience in Healthcare Compliance, Quality Improvement, and Regulatory Compliance, including training, policy management, investigations, auditing and corrective action plans.
  • Previous management experience working effectively with multi-functional areas.
  • Other Skills and Abilities:Ethical conduct.
  • SharePoint skills a plus.
  • High degree of professionalismTravel Requirements:Minimum travel requiredWork Environment:ProfessionalOffice settingWe are an equal opportunity employer.

Similar jobs:

  • All Jobs
  • Active
LTSS Case Manager
Molina HealthcareBonita Springs, FL
Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program.
Pharmacy Manager Sign on Bonus Available
WalgreensBonita Springs, FL
Manages pharmacy asset protection activities and oversees inventory management through Pharmacy Operations Manager.
Manager Pharmacy - Coconut Point
Lee HealthEstero, FL
Serves as a liaison to Nursing and Medical Staff to ensure and oversee the provision of safe, effective, and efficient patient-centered pharmacy services including but not limited to: medication acquisition, storage, security, preparation, and distribution.
Operations Manager
CVS HealthNaples, FL
Customer service leadership Unlike the Store Manager in Training position, the Operations Manager position is not part of the CVS/pharmacy Retail Management Development Program.
$17 - $20.5 an hour Full-time
Coding Compliance Auditor
Healthcare Network of Southwest FloridaNaples, FL
Healthcare Network (HCN) is a Federally Qualified Health Center (FQHC) serving as the medical home for patients from birth to geriatric.
How to Add a Resume to LinkedIn

Other than Job Searcher, LinkedIn is one of the better places to be if you want to be discovered by employers or even if you just want a place to get the latest updates on your industry or network. Having an active account on LinkedIn is the perfect opportunity to show off your qualifications, achievements, and experience. Employers will often look at job applicants’ LinkedIn profiles to gain some more insight, so it’s important your profile is looking its best. 

RN - Case Manager
Home InsteadBonita Springs, FL
Home Instead, the premier provider of home care in southwest Florida, is looking for a Registered Nurse Case Manager to oversee client care ensuring that the highest quality service is being provided to each senior we serve.
Assistant Store Manager
SmartStop Self StorageNaples, FL
Navigating multiple surfaces: indoors and outdoors; carpet, tile, linoleum, cement, pavement, dirt - surfaces may uneven, hot, icy, snowy
$14.5 an hour Full-time
Assistant Store Manager
Family DollarNaples, FL
We offer generous benefits, flexible work schedules and the ability to work today and get paid tomorrow.
Regional Manager
MainscapeFort Myers, FL
The Regional Manager will work closely with the Branch Managers to ensure successful branch functionality including, building a team, completing contracted operations, acting as a partner to our customers, and fulfilling all of the internal needs to successfully run our business.
9 Best Jobs for Introverts

If you really think about it, we aren’t actually either introverts or extroverts. Instead, we’re all on a spectrum as ‘Big Five’ personality tests characterize. Someone more on the side of extroversion would enjoy social contact more, especially large group projects and company parties. It seems as if modern workplaces seem tailor-made for extroverts with the open plan layouts, which removes barriers between people. However, it seems there are very few options that would be perfect jobs for introverts that don't always require working from home.

Assistant Deli Manager - CMS
The Fresh Market IncBonita Springs, FL
As our Assistant CMS Manager, you will assist the Deli/CMS Manager with department directing team members, inventory management, pricing integrity, and other operational processes to provide the best products and the excellent convenient meal solutions for our guests to deliver results.
Facilities Manager
Bonita Springs Poker RoomBonita Springs, FL
As the Facilities Manager your responsibilities include a hands-on approach to overseeing the daily operations of the maintenance and housekeeping department in the absence of the Director of Facilities.
Case Manager Certified - Temp
Lutheran Services FloridaEstero, FL
To fully understand case ownership responsibility as the integrator of all services and supports identified for each child, including therapy, other mental health services, health and dentistry, developmental services, educational support, permanency and safety; as well as their responsibility to make trauma sensitive transitions when it is determined that a caretaker lacks the needed level of responsibility to care for their children.
Assistant Project Manager
Suffolk Construction CompanyEstero, FL
Associated topics: chief program officer, cpo, manage, manager, management, monitor, product manager, project manager, relationship manager, task
17 High Paying Jobs That Don't Require a Degree

After graduating high school, many students' first thoughts aren't focused on trying to find the highest paying jobs that don't require a college degree. Many go to college to further diversify their skills so they can get a high paying job, but college is not for everyone. Some people can’t afford to continue their education at a university. Others may just not like going to school. 

Assistant Project Manager
Suffolk ConstructionEstero, FL
2+ years of related experience or completion of Suffolk's Career Start Program as a Project Engineer or Project Engineer with another firm
IT Project Manager
ModisBonita Springs, FL
If you are interested in this IT Project Manager job in Southwest, FL then please click APPLY NOW or e-mail David.

Latest Blog Posts: to Respectfully Put in Your Two Weeks NoticeThe best reason for leaving a job is finding a new one. Whether you hate your job and can't cope, you’ve found someone who pays more, or you’ve found a way of advancing your career, it just may be time to leave. But how should you do it? Do you need to write a two weeks notice letter? If so, what are you supposed to write? to Expect in a Job Offer LetterReceiving a job offer with an offer letter is a great step in the right direction during your job search. It is a sign that the job application process went really well, and you shined amongst the rest of the candidates. If a company wants you to work with them after doing a series of interviews, personality tests, and so on, you will receive a job offer letter. Effective Communication Skills to Help Advance Your CareerWhen you apply for a job, you will be asked if you have certain skills. For instance, your employer may want to find out if you are familiar with Microsoft Office software or if you can use QuickBooks or Photoshop. Hate My Job! 3 Ways to Cope with a Job You HateWhen we start a job, our expectations are that we will love it, or at least enjoy it. From our early days of school, we are told to “work in a job you love”. As lovely as this sounds, this is life and nothing in life is as straightforward as we hope. There are bumps on the road, and this extends to our work lives too. Unfortunately, many people throughout their working years will find themselves thinking "Wow, I hate my job." Guide to Getting Paid on Federal HolidaysEveryone looks forward to federal holidays. For a lot of people, it’s more about getting the time off work than the holiday itself. Tips to Write the Perfect Job Application EmailJob application emails are a necessary part of your job hunting checklist. Applying for jobs can be done in many different ways, such as online platforms, by email, and if you like to be old school, you can drop off your resume by hand. In current times, applying for jobs through email is a popular method. With this in mind, it’s important to know what exactly a job application email should include and how to compose one. So let’s break it down bit by bit and gain a better understanding of job application emails. This article will equip you with everything you need to write a perfect professional job application email in no time. Tips to Answer The Dreaded Salary Expectations Question + Example AnswersWhen it comes to the big “salary expectations” question in an interview, people often seem to dread this conversation. It can be awkward discussing salaries and finances at a job interview, but it is an important aspect of figuring out if the job is a good fit for you.