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Company

Point32Health · 1 day ago

Compliance Program Manager III

Massachusetts, United States

Full-time

Remote

Mid, Senior Level

5+ years exp

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Responsibilities

Management of cross-functional compliance projects and initiatives

Proactive and solutions-oriented management of compliance initiatives and integration issues, requiring the ability to conceptualize and envision the impact of regulatory and business changes to the internal compliance readiness, and propose ways to meet regulatory obligations by understanding business functions and needs.

Management of regulatory audits to ensure alignment in approach across compliance departments and with the rest of the organization.

Evaluating and analyzing regulations and sub-regulatory guidance, interpreting their significance, and recommending policies to ensure compliance.

As directed, support risk assessments using data analytics and regulatory insights

Leading and/or managing projects and initiatives by representing regulatory and compliance expectations and requirements during the planning and implementation phases. This includes coordinating issue resolution with relevant business areas and facilitating planning and review sessions.

Providing support in the overall management of compliance program key functions, including developing compliance workplans across all elements of an effective compliance program, including (but not limited to): Risk Assessment; Monitoring and Auditing; Effective Communication; Training and Education; Policies and Procedures; Vendor Oversight; Issue correction and remediation.

Support the strategic priorities of the organization and compliance program through annual planning, enhancing compliance functions, and driving future needs to support ongoing compliance development activities.

Support the development of monthly and/or quarterly compliance reporting as required by management and organizational Committees.

Understand regulatory requirement and industry, to help drive a successful compliance program through prevention, detection, and correction of potential issues of noncompliance and/or fraud.

Qualification

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Regulatory complianceRisk managementProject managementData analyticsMicrosoft Office

Required

Bachelor’s Degree or equivalent work experience

5-8 years of regulatory, compliance and legislative activities, health insurance operations or legal research or equivalent combination of education and experience

3+ years of Medicare, Medicaid and/or commercial compliance experience

Excellent verbal and written communication skills generally acquired through college or other advanced education

Ability to facilitate planning and review sessions

Ability to communicate with internal and external constituents at all levels with confidence

High level presentation skills including ability to interface effectively with internal and external contacts and present technical information in a way that establishes rapport and gains understanding

Ability to exercise sound judgment and raise issues and potential solutions to appropriate team members or management for resolution

Ability to conceptualize the impact of change and propose new methods of conducting business

Strong analytical skills to develop new or implement change to existing program functions

Ability to interpret and explain the implications of planned changes to current state business units

Ability to problem solve and overcome obstacles to ensure successful program operations

Proficiency with Microsoft Office applications (Word, Excel, PowerPoint)

Ability to utilize multiple applications simultaneously

Requires the ability to work cooperatively as part of a team

Must be able to effectively communicate with all internal departments in verbal and written formats

Must be able to work in a matrix environment with minimal supervision

Using knowledge of the company, able to resolve most roadblocks to program progress

Ability to operate and thrive in a matrixed-management, hands-on environment that demands a consultative approach and solutions environment with minimal supervision

Able to navigate issues using advanced organizational knowledge

Is an effective, strong advocate for the program and negotiates/leads others both internally and externally to participate to ensure success in the program

May be required to coach/mentor less experienced staff and effectively lead in a matrixed environment

Proactively identifies conflict/integration issues and leads team members to parse/synthesize issues of the highest complexity

Ability to identify risk out of the larger picture and develop risk analysis for consideration

Content knowledge of the specific program

Must be able to converse and lead dialogue on the subject with minimal direction

Must be flexible and a proponent/champion of change

Able to conceptualize and envision the impact of change, and propose new ways to do business