**Resp & Qualifications**

**PURPOSE:**
This role manages vendor and vendor compliance programs, including program integrity for the Government Programs division. Ensures plan is in compliance with government contract and regulations. Conducts risk assessments, internal and external audits and investigations. Reviews the vendor compliance program and program integrity program for CMS, state regulatory bodies and delegated vendors.

**ESSENTIAL FUNCTIONS:**

+ Ensures compliance with policies and procedures and governmental/accreditation regulations for Medicaid and Medicare Advantage Vendors. Assist with conducting investigations of compliance violations. Responsible for managing the day to day governance process around contracting and reporting on vendor performance metrics and issue resolution.
+ Assist with the development of compliance policies impacting vendors for review and approval by leadership and ensure regular policy review and consistency wi...