Under limited supervision, the Compliance and Reporting Manager provides regulatory guidance to the Georgia Access division through analysis, interpretation of applicable laws, rules and regulatory requirements.

Establishes reporting mechanisms for federal compliance, develops mandated reports and ensures compliance with both federal and state audits.

Reviews and draft 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.

Defines Key Performance Indicator (KPI) standards across Georgia Access business units to evaluate effectiveness in meeting program goals and objectives.

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

Coordinates with the State Auditor’s Office and external auditors to conduct Centers for Medicare & Medicaid Services (CMS) required financial and programmatic audits.

Coordinates with internal/external auditors to conduct Centers for Medicare and Medicaid Services (CMS) financial and programmatic audits.

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 other duties assigned.