Optimization Oversight Coordinator Jobs

Experience within Healthcare, Pharmacy Benefit Management (PBM), and/or Insurance industries.

Experience in Pharmacy Benefit Management (PBM) within Quality Assurance or Configuration.

Collaborate with the Prescription Drug Event (PDE), Quality Action Notice (QAN), Audit and Regulatory Committee Management (RCM) when requested.

Collaborate in the development of new logics and procedures to improve processes in your areas of responsibilities.

Write and update policies and procedures in your areas of responsibilities.

Review prescriptions and other auditable documents to verify compliance with Centers for Medicare & Medicaid Services (CMS) requirements and contractual requirements.

Excellent planning, time management and coordination skills.

6+ years’ experience in monitoring and site management of industry sponsored clinical research (CRA, Clinical Trial Monitor, or equivalent).

excellent planning, time management and coordination skills.

Addresses issues identified with study conduct, monitoring and site management with Sponsor’s management, are appropriately communicated/escalated and follows up through resolution.

Demonstrated management of monitoring and site management tasks.

The ability to identify, solve and escalate issues that arise at study sites and within site management

Experience in remote work Collaboration Software.

Bachelor’s degree in business process engineering or equivalent work experience.

Cross functional experience with multiple mortgage servicing business.

Excellent communication skills both written and verbal.

includes the following responsibilities, but not limited to

Monitor subservicer performance on KPI, but not limited to:

Experience in remote work Collaboration Software.

Bachelor’s degree in business process engineering or equivalent work experience.

Cross functional experience with multiple mortgage servicing business.

Excellent communication skills both written and verbal.

includes the following responsibilities, but not limited to

Monitor subservicer performance on KPI, but not limited to:

Knowledge of financial management, budgeting, and purchasing as it pertains to a child and youth program.

Ability to supervise others, exercise sound business skills, and provide positive personnel management.

If you are relying on your education to meet qualification requirements:

Must meet the requirements listed the Education section of this announcement.

Knowledge of DOD, DON, local and state regulations, instructions and procedures pertaining to military child care.

Knowledge of Federal and State laws governing the detection and prevention of child abuse and/or neglect.

2+ years of project management experience managing multiple diverse projects

Review and ensure the vendor network meets member care and state contractual accessibility and availability requirements

Validate vendor processes, policies and other documentation align with state contractual and accreditation requirements

Bachelor’s degree or equivalent experience

2+ years of experience managing and/or driving vendor or team performance

1+ years of experience demonstrating the ability to coordinate with external community-based organizations and/or transportation service providers

1-3 years’ experience in the investment management field including experience in investment portfolio compliance or other areas of compliance

Tracking new account and amendment onboarding status, providing reporting and updates to management;

Performing pre and post trade compliance monitoring for all asset classes on commingled funds, separately managed accounts, and registered funds;

Manage and provide support to completion of new account/amendment onboarding process to ensure that appropriate reviews and sign-offs are timely obtained

Demonstrated communication and interpersonal skills

Strong analytical skills and organizational skills

Solicitation For Profile Of Personal Qualifications

Law school professor with expertise in the area of employment law or;

A member of the American Arbitration Association

7+ years of experience in credit risk management, analytics, collections, governance, or compliance at a large complex financial institution

Maintenance of Enterprise Collection management policies

Provide summary and escalations to senior management, committees, relevant risk working groups and boards

Manage enterprise-wide credit and negative balance collection oversight framework and governance including:

Experience with Risk oversight function within a multidivisional and complex organization is a plus

Oversight of Collection KPI and Risk triggers to monitor the collection portfolio

Maintain current knowledge of issues impacting the program.

Develop relevant standard operating procedures as related to responsibilities under this role.

At least three years of experience in program oversight or monitoring.

Experience in domestic resettlement/ the US Refugee Admissions Program required.

Direct experience with community sponsorship is a strong asset.

Experience creating monitoring and oversight tools.

Serve as the primary subject matter expert and leader on all aspects of SoFi’s Compliance Management Program governance.

Ensure quality and on-time preparation of senior management materials, meeting minutes and follow-ups and materials for board, audit, and regulatory communication

Accountable for implementing and executing a program management structure to deliver expected plan outcomes and timely execution of transformation plan deliverables

Identify and manage execution risks and escalate to senior management and required governance forums, as necessary

Mentor and manage others to increase team competency, continually build a culture of constant improvement and a desire to excel.

Strong communication skills, influencing decisions through advice, and counsel.

Serve as the primary subject matter expert and leader on all aspects of SoFi’s Compliance Management Program governance.

Ensure quality and on-time preparation of senior management materials, meeting minutes and follow-ups and materials for board, audit, and regulatory communication

Accountable for implementing and executing a program management structure to deliver expected plan outcomes and timely execution of transformation plan deliverables

Identify and manage execution risks and escalate to senior management and required governance forums, as necessary

Mentor and manage others to increase team competency, continually build a culture of constant improvement and a desire to excel.

Strong communication skills, influencing decisions through advice, and counsel.

Serve as the primary subject matter expert and leader on all aspects of SoFi’s Compliance Management Program governance.

Ensure quality and on-time preparation of senior management materials, meeting minutes and follow-ups and materials for board, audit, and regulatory communication

Accountable for implementing and executing a program management structure to deliver expected plan outcomes and timely execution of transformation plan deliverables

Identify and manage execution risks and escalate to senior management and required governance forums, as necessary

Mentor and manage others to increase team competency, continually build a culture of constant improvement and a desire to excel.

Strong communication skills, influencing decisions through advice, and counsel.

Serve as the primary subject matter expert and leader on all aspects of SoFi’s Compliance Management Program governance.

Ensure quality and on-time preparation of senior management materials, meeting minutes and follow-ups and materials for board, audit, and regulatory communication

Accountable for implementing and executing a program management structure to deliver expected plan outcomes and timely execution of transformation plan deliverables

Identify and manage execution risks and escalate to senior management and required governance forums, as necessary

Mentor and manage others to increase team competency, continually build a culture of constant improvement and a desire to excel.

Strong communication skills, influencing decisions through advice, and counsel.

Serve as the primary subject matter expert and leader on all aspects of SoFi’s Compliance Management Program governance.

Ensure quality and on-time preparation of senior management materials, meeting minutes and follow-ups and materials for board, audit, and regulatory communication

Accountable for implementing and executing a program management structure to deliver expected plan outcomes and timely execution of transformation plan deliverables

Identify and manage execution risks and escalate to senior management and required governance forums, as necessary

Mentor and manage others to increase team competency, continually build a culture of constant improvement and a desire to excel.

Strong communication skills, influencing decisions through advice, and counsel.

7+ years of experience in vendor management

Strong leadership and relationship management experience

Manage strategic relationship(s) with key TD Business Management, Control Partners, Executive teams, and our Partners.

Manages strategic relationship(s) with key TD business management and executive teams

Takes the lead in the development of strategic direction, operating budget, delivery of business objectives, efficiencies, innovation, and people management

Manages portfolio with high regulatory requirements

Experience with MCO (Managed Care Organization) operations relative to care management, utilization management or appeals and grievances.

Knowledge of internal quality controls in compliance with department policies and procedures.

Social skills to interact with a wide range of constituencies.

Must have critical thinking and problem-solving skills.

Ability to pay attention to detail with emphasis on reporting skills.

General computer skills, including but not limited to: Microsoft Office, information security, electronic medical documentation, and email.

2 years of experience within a managed care plan and quality management required.

Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.

Informs various departments of changes to regulatory requirements.

Ensures vendors remain in accordance with the regulatory requirements or contractual obligations.

Serves as knowledge expert for assigned functional areas; may act as a liaison with other areas and business units.

2 years of audit experience in the health care field required.

Maintains a record of ongoing cases of alleged fraud or misuse of funding in the context of Country-Based Humanitarian Pooled Funds.

Organizes and participates in work groups, meetings, conferences, consultations with other agencies and partners on humanitarian and emergency relief-related matters.

Performs other duties as required.

Bachelor’s degree in Transportation, Urban Planning, Business, Public Policy, Construction Management, Finance/Economics, or a related field.

Based on evaluation of education, skills, experience, and interview.

An equivalent combination of education and experience may be considered.

Demonstrated analytical capabilities and quantitative skills.

The MTA encourages qualified applicants from diverse backgrounds, experiences, and abilities, including military service members, to apply.

Day-to-day responsibilities depend on the assigned area and may include the following: