Program Director Medicare Compliance

This is a modified hybrid role: 1-2 days per week. Location is Hanover, MD. The Johns Hopkins Health Plan is seeking a driven Program Director - Medicare Compliance to lead our Medicare compliance program and ensure full adherence to CMS and regulatory requirements. This role oversees daily program operations, guides compliance strategy and structure, manages staff, and partners across the organization and with FDRs to promote a strong culture of compliance. The Program Director drives auditing and monitoring efforts, leads key committees, liaises with regulatory agencies, and oversees corrective action and implementation of new guidance to maintain an effective, proactive compliance program. Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3.2B business serving nearly 500,000 members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider sponsored health plans—backed by the clinical expertise of Johns Hopkins Medicine—and is poised for future growth. Education/Certification: Bachelor’s degree in Health Management, Business or other applicable concentration Master’s degree or Juris Doctorate preferred Certification in Health Care Compliance, Fraud Examination or Internal Audit is preferred Requirements: A minimum of 5-7 years in a Medicare Compliance program and 3-5 years of management and supervisory experience Knowledge of CMS Medicare Advantage and Part D contractual and regulatory requirements Expert level knowledge of HIPAA requirements, 42 CFR 422, 42 CFR 423, Inflation Reduction Act, OIG Compliance Guidelines, and other key regulations related to public health Understanding of Maryland payment methodology and Health Services Cost Review Commission strongly preferred #J-18808-Ljbffr Johns Hopkins Medicine