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Compliance Audit Operations Managerement Audit)

Date:  Apr 6, 2021
Brand:  EyeMed Vision Care
Location: 

Mason, OH, US, 45040

Requisition ID: 335032 
Position:Full-Time
Total Rewards: Benefits/Incentive Information

 

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same.  And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

 

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear.  In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands.  Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, Target Optical and Sears Optical.

 

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The Manager - Operations Compliance Management is part of the team that represents Operations for Compliance requests, for all lines of business. They lead the preparation, delivery, and they participate in client audits that review all processes within Operations. The Manager has accountability for any follow-up activities that may result from audit findings, including the development of Corrective Action Plans (CAPs) responses and their timely completion. The Manager collaborates closely with the Compliance Team to drive compliant practices and act as an Operations Compliance subject matter expert (SME).

 

MAJOR DUTIES AND RESPONSIBILITIES

  • Acts as the Operations SME and collaborates with the Compliance Audit Team in preparing for, and delivering on, client audits.
  • Represent Operations in all client audits, including the delivery of audit deliverables; response documentation; case development, webinar presentation, and all other audit activity as needed.
  • Identifies, tracks, and reports on correction activities taken and results.
  • Develops recommendations to remediate known issues or issues found in an audit.
  • Leads the collection of data for regulatory filings and assist with regulatory reporting for their operational area.
  • Prepares accurate and timely formal written reports on oversight and monitoring activity findings and recommendations and properly prepare supporting work papers.
  • Directs compliance issues to appropriate channels for research and resolution.
  • Partners with the Compliance Programs team to assure consistent problem resolution occurs across the organization.
  • Identifies opportunities for training where previous instances of non-compliance have been identified and deliver training where applicable
  • Maintain strict adherence to all HIPAA and corporate data security guidelines/regulations
  • Organizes and directs the remediation and closure of Correction Action Plans with functional leaders in Operations as needed

 

BASIC QUALIFICATIONS

  • Bachelor's Degree or equivalent work experience
  • 5+ years of related experience in compliance or claims based organization
  • Ability to influence internal constituents
  • Analytical approach to process review and results
  • Demonstrated project management skills
  • Collaborative work style with the ability to build partnerships, teamwork, and good working relationships
  • Demonstrated ability to deal with confidential information
  • Ability to effectively present information and respond to questions from peers and management
  • Ability to work in a fast-paced environment with changing priorities
  • Intermediate-level experience with Microsoft Office Products (Word, PowerPoint, Excel)

 

PREFERRED QUALIFICATIONS

  • Knowledge of the Medicare Advantage (MA) and Medicaid regulatory regulations
  • Proven experience in performing effective monitoring and oversight
  • Understanding of the regulatory framework within which the company operates
  • Intermediate-level experience with Microsoft Project
  • Experience with the Facets Core platform, specifically Medical Claims Processing

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 or e-mail HRCompliance@luxotticaretail.com (be sure to provide your name and contact information for either option so that we may follow up in a timely manner). 

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law.  Native Americans receive preference in accordance with Tribal Law.


Nearest Major Market: Cincinnati

Job Segment: Operations Manager, Medical, Medicare, Medicaid, Operations, Healthcare

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