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Job Category:

Medical, Compliance


Pay:

To be discussed.


Overview

ESSENTIAL RESPONSIBILITIES:

Compliance Monitoring:

* With supervision from the Medicare Compliance Manager, execute compliance monitoring (CM) assessments of sales agents, document results within established repository in accordance with defined departmental policies and procedures, report CM Assessment results to the Medicare Compliance Manager and applicable Sales Management team members.

* Participate in conference calls with eHealth Clients to discuss Compliance Monitoring results to foster a strong partnership with the client and validate the CM efforts taken on behalf of client.

* Assist in retrieving call recordings at the request of eHealth clients and submitting them within the client’s established timeframes.

* Assist in communication of compliance monitoring results from eHealth Clients to Sales Leadership and coordinate any follow-up requested.

* Partner and collaborate with the Sales Team on communicating the CM results in an effective and thoughtful manner. Assist with sales agent coaching and formal and informal re-training via conference calls, meetings, written communications such as memorandums and training presentations.

Other Duties:

* Maintain working knowledge of all applicable Centers for Medicare & Medicaid Services (CMS) regulatory guidance with the ability to interpret and communicate to others in layman’s terms.

* Works with call center business units to increase awareness of the importance of the compliance, FWA plans and the Code of Conduct.

* Other duties as assigned.

MINIMUM QUALIFICATION/REQUIREMENTS:

* Two (2) years prior experience at a Medicare Advantage Organization or Prescription Drug plan Sponsor (prior experience with Appeals and Grievances strongly preferred).

* BA/BS Degree preferred.

* Knowledge of risk assessment concepts.

* Must be detail oriented with good organizational, written and verbal communication skills.

* Ability to work in a fast paced environment and effectively prioritize work to meet internal and external deadlines.

* Proficiency in Microsoft applications (Word, Excel, PowerPoint and Outlook).

PREFERRED QUALIFICATIONS:

Other related skills and/or abilities may be required to perform this job.

eHealth is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race, color, religion, sex, national origin, age, marital status, sexual orientation, genetic information, disability, protected veteran status, or any other consideration made unlawful by applicable federal, state or local laws. The foundation of these policies is our commitment to treat everyone fairly and equally and to have a bias-free work environment.

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