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Compliance, Privacy, and Contract Manager

Medical Associates

1 Positions

ID: ocAOwfwQ

Posted On 08/01/2025

Job Overview

Description

Medical Associates Health Plans is hiring a **Compliance, Privacy, and Contract Manager** to join our team! This role will report to our Chief Operating Officer to help provide organization-wide support and leadership regarding compliance, privacy, and contracting related programs and processes.

Where You Will Be Working:

Medical Associates Clinic and Health Plans is a multi-specialty group practice combined with a growing health insurance company. Our 1,100 healthcare and health insurance professionals lead the way in providing quality healthcare and top-notch insurance products in Northeast Iowa, Southwest Wisconsin, and Northwest Illinois. This position is an onsite position, based out of the compliance department located at the Medical Associates Health Plans in Dubuque, Iowa.

Skills You Bring:

+ Solid interpersonal skills and ability to work collaboratively and lead effectively while influencing positive change.

+ Strong organization skills, multitasking, and follow-through

+ Positive, energetic personality with ability to make quick, tough decisions

+ Preference will be given to candidates with a legal background

Benefits Package Includes:

+ Single or Family Health Insurance with discounted premium rates for wellness program participation.

+ 401k with immediate matching (50% on the dollar up to 7% of pay) + additional annual Profit Sharing

+ Flexible Paid Time Off Program (29 days off/year)

+ Medical and Dependent Care Flex Spending Accounts

+ Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

Major Responsibilities:

MAHP Compliance

+ Develop and maintain processes, systems and explicit measures that ensure timely and accurate execution of compliance requirements.

+ Lead and oversee all health plan compliance policies and procedures and assist in updating or developing new policies to improve operations, advance internal controls, or to meet new regulations/requirements.

+ Provide compliance review of federal, state, Center for Medicare and Medicaid Services (CMS) and Department of Insurance (DOI) requirements.

+ Lead the Compliance team, establish annual objectives, provide ongoing feedback and support, create capacity plan,

+ Serve as a consultant to the health plan for compliance and regulatory questions and concerns. Identify when an issue or question requires outside support or counsel.

+ Coordinate with the Analytics Department on internal monitoring and auditing for policy compliance, discover preventive and corrective measures executed for audit findings and coordinate internal and external corrective measures to be executed.

Regulatory Compliance and Oversight

+ Be informed of current legislation and enforcement issues affecting the healthcare industry, including but not limited to Medicare Cost Plan requirements, Commercial Health Plans, Clinical Quality, Pharmacy and PBMs, Accreditation, compliance best practices, and HIPAA.

+ Work closely with departments for effective investigation, resolution, reporting, and remediation of compliance issues. Prepare report for management on incidents, investigations, and all compliance issues and present at Compliance Committee meetings when appropriate.

+ Responsible for communication and coordination of issues requiring external counsel or external carrier support, guidance, or expertise. Ensure appropriate external expertise is in place to cover the work being performed.

Contracting

+ Maintain entity provider contract templates for MAHP in compliance with federal, state, CMS and DOI requirements as may be applicable.

+ Perform annual review and then as needed during the negotiation process.

+ Develop and maintain contract oversight and checkoff process to assure proper review, signoff and management of entity contracts.

+ Consult with health plan team related to contracts and contracting process.

Serve as the Medical Associates Privacy Officer for both the MA Clinic and MA Health Plans. Oversee Medical Associates HIPAA Compliance program, including monitoring changing regulatory environment and performing audits such as electronic medical record tracking and personnel audits as needed. Annual review of all related documents and processes related to meeting Privacy requirements.

Knowledge and Skills:

Experience Three years to five years of similar or related experience.

Education Juris Doctor (J.D.) degree from an approved law school, with admittance to at least one state bar in good standing is preferred.

Interpersonal Skills A significant level of trust and diplomacy is required, in addition to normal courtesy and tact. Work involves extensive personal contact with others and/or is usually of a personal or sensitive nature. Work may involve motivating or influencing others. Outside contacts become important and fostering sound relationships with other entities (companies and/or individuals) becomes necessary.

Other Skills Possess relevant certification in healthcare compliance, such as or CCEP, CHC, CHC-F, or CHRC, or a Certified Fraud Examiner (CFE) certification, or successful completion of a graduate certification program in healthcare compliance. Strong knowledge of Excel, PowerPoint, and SAP.

Physical Aspects:

Reaching - Extending hand(s) and arm(s) in any direction.

Lifting - Raising objects from a lower to a higher position or moving objects horizontally from position-to-position. This factor is important if it occurs to a considerable degree and requires the substantial use of the upper extremities and back muscles.

Fingering - Picking, pinching, typing or otherwise working, primarily with fingers rather than with the whole hand or arm as in handling.

Grasping - Applying pressure to an object with the fingers and palm.

Talking - Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly or quickly.

Hearing - Perceiving the nature of sound with or without correction. Ability to receive detailed information through oral communication and to make fine discriminations in sound, such as when making fine adjustments on machined parts.

Repetitive Motions - Substantial movements (motions) of the wrists, hands and/or fingers.

Sedentary Work - Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Environmental Conditions:

None - The worker is not substantially exposed to adverse environmental conditions (such as in typical office or administrative work).

Medical Associates Clinic & Health Plans is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, age, national origin, marital status, parental status, disability, veteran status, or other distinguishing characteristics of diversity and inclusion, or any other protected status.

Please view Equal Employment Opportunity Posters provided by OFCCP https://www.eeoc.gov/poster

Primary Contact

9878

Careers at Medical Associates

,

563-584-4225

Phone

Phone

Phone

Fax

[email protected]

Email

True

False

True

Job Details

Categories

Health Care

Management/Executive

Location

Dubuque, IA

Job Type

Employee

Full/Part

Full Time

Company ID

1148

Job REQ #

ocAOwfwQ

\# Positions

1

Start Date

20250801

End Date

20250813

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Medical Associates

About the Company

_Our mission is to provide superior healthcare and an excellent patient experience._

Medical Associates Clinic is a well-established multispecialty group practice with over 170 providers and a staff of over 1,000 health care professionals and support personnel. The group was founded in 1924 and is Iowa’s oldest multispecialty group practice. Today, Medical Associates Clinic is the area’s leading health care provider and only multispecialty group practice. Medical Associates Clinic has been recognized since 1998 as a “better performing practice” by the Medical Group Management Association.

In 1982, Medical Associates developed the Tri-State’s first health maintenance organization, Medical Associates Health Plans, which offers comprehensive health benefits to over 400 employers and 45,000 members. Medical Associates Health Plans has maintained an “Excellent” rating, the highest level of accreditation possible by the National Committee for Quality Assurance, for 13 consecutive years.

Medical Associates Clinic offers several locations from which to seek medical care, including facilities at 1500 Associates Drive, 1000 Langworthy, and 4155 Pennsylvania Ave in Dubuque, Iowa; as well as facilities in Bellevue, Cascade, Dyersville, Iowa; Cuba City, and Platteville, Wisconsin; and Elizabeth and Galena, Illinois.