Policy and Compliance Manager - State Based Exchange

Under limited supervision, the Policy and Compliance Manager establish reporting processes and procedures, develops mandated federal/state reports and collects and distributes data to ensure compliance with federal and state audits for Georgia's State Based Exchange.

Reviews and drafts commentary on annual updates to federal guidelines in the Notice of Benefit and Payment Parameters (NBPP) to reflect Georgia Access positions on regulatory guidance; with support from other Georgia Access business units.

Reviews and submits reports (e.g., the State-based Marketplace Annual Reporting Tool, an Oversight and Monitoring Plan, Programmatic and Financial Audits, and Annual Financial Statements) to CMS and serve as the main point of contact for federal reporting matters.

Implements processes for data collection, analysis and report presentation to track program compliance with health insurance marketplace regulations and internal KPIs.

Coordinates with departmental staff reviews of federal/state legislation and regulation.

Coordinates new and updated rollout requirements for the Exchange.

Assists in the development of policies and procedures for assigned area.

Supervises subordinate staff.

Ensures the appropriate dissemination and communication of all pertinent regulations, policies, and guidelines.

Performs investigations, accountability audits, and other such duties related to alleged violations of all applicable statutes, standards, rules, and regulations.

Performs other duties assigned.