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Community Care Cooperative (C3) · 3 days ago

Senior Director, Compliance and Contract Management

Boston, MA

Full-time, Contract

Hybrid

Lead/Staff, Director/Executive

5+ years exp

Community Care Cooperative (C3) is a non-profit Accountable Care Organization (ACO) dedicated to improving health and wellness through innovative partnerships and programs. The Senior Director of Compliance and Contract Management is responsible for ensuring compliance with value-based contracts and managing risks while enhancing quality of care across the organization and its subsidiaries.

Health CareHospitalNon ProfitSocial

Responsibilities

Manage C3’s compliance function for its risk contracts, including the MassHealth ACO contract, ACO REACH, and MSSP

Take all necessary steps to protect C3 and contracted entities from business risks due to insufficient or inadequate compliance functions, policies and/or procedures

Manage the Policy and Procedure Committee to ensure Compliance Policies and Procedures are complete, accurate, and up-to-date for all lines of business

Ensure C3 and all subsidiaries are in compliance with applicable internal P&Ps and laws and regulations

Ensure health centers are compliant with their duties and obligations as it relates to compliance with C3’s risk contract(s); this includes monitoring and identifying solutions to new and changing contract requirements, supporting program communications and completing program deliverables

Serve as a company resource for compliance and contract-related knowledge, questions, problem solving, and issue resolution

Stay current on related industry trends / best practices and communicates to stakeholders

Perform root cause analysis on complex issues that impact program performance and works with other teams to proactively craft and implement solutions

Serve as a designated key contact / liaison with government agencies, including MassHealth and CMS, for compliance related issues, including scheduling and participating in meetings and other initiatives relative to our ability to properly function as an ACO

Oversee Board Compliance Committee activities

Oversee the compliance activities for subsidiary companies

Participate in the CTC Privacy Taskforce to support health centers, as appropriate

Serve as direct supervisor for Compliance team

Other special projects and duties as assigned

Qualification

Healthcare complianceContract managementRegulatory oversightData analysisMicrosoft applicationsCustomer service mindsetCommunicationAttention to detailTeam collaboration

Required

Strong healthcare compliance and contract management knowledge and experience

Demonstrate the ability to synthesize and communicate complex information verbally and in writing

Possess business acumen for ensuring effective policies, procedures, and processes are established, documented, and implemented

5-7 years of professional experience in healthcare compliance, ideally with some Medicaid (or Medicare) experience

Prior contract management experience

Experience managing multiple competing priorities; excellent prioritization skills

Strong analytical and organizational skills including ability to analyze data to identify trends and communicate them through effective reporting methods

Close attention to detail

Excellent oral, written, and verbal communication skills including experience presenting compliance information to senior leaders

Skilled in exercising a high degree of initiative, judgement, discretion and decision making to achieve objectives

Track record of success as part of multidisciplinary teams that share and leverage the strengths of diverse members

Quick learner with customer service mindset

Proficiency in Microsoft applications (Word, Excel, PowerPoint, Outlook)

Preferred

Familiarity with the MassHealth ACO program

Familiarity with Medicare programs

Familiarity with Federally Qualified Health Centers

Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Juris Doctor (JD) or Master's Degree in a related field preferred but not required (public health, public policy, healthcare management)

Candidates with significant legal, compliance, or regulatory experience will also be considered

Company

Community Care Cooperative (C3)

Community Care Cooperative (C3) exists to deliver great health care to all by offering a series of health plans uniquely tailored to meet each individual’s medical needs, no matter what road they are on in their healthcare journey.

Founded in 2016

Boston, Massachusetts, USA

201-500 employees