113 applicants

Company

Cloud and Things · 11 hours ago

Senior Director of Compliance

United States

Full-time

Remote

Director/Executive

10+ years exp

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Responsibilities

Provides oversight and governance for the company’s Compliance Program.

Provides strategic guidance to company leadership on compliance matters.

Promotes and fosters compliance with applicable laws, regulations, contractual requirements, and industry standards

Develops, implements, and updates compliance policies, standards, and processes, including the Compliance Program Plan and the Employee Code of Conduct.

Ensures that compliance policies, standards and processes are reviewed annually and updated accordingly.

Oversees employee compliance training and awareness programs.

Oversees initial and monthly employee screening processes.

Oversees investigations and responses to compliance-related incidents, including privacy and security incidents.

Ensures that all aspects of the investigation are reviewed and documented, including root cause analyses.

Oversees reporting incidents to clients and third parties, when applicable

Ensures that identified remedial actions are implemented and monitored.

Oversees required client-required compliance attestations, certifications, and disclosures.

Oversees required client-required enrollment processes

Oversees compliance with contractual insurance requirements.

Oversees insurance claims processes.

Manages the company’s risk assessment program and implements measures to mitigate compliance and operational risks.

Maintains the company’s risk registry

Facilitates and documents Risk Management Committee meetings

Manages action items from Risk Management Committee meetings

Oversees the company’s vendor management program.

Prepares compliance-related materials for Board of Directors meetings, including annual training and attestations.

In coordination with Quality Improvement personnel, develops and oversees internal audits of various company operations.

Oversees mandatory compliance reporting to third parties (including suspected incidents of fraud, waste, and abuse).

Oversees regulatory examinations and audits.

Oversees the implementation of corrective actions needed in response to compliance-related incidents and internal and external audits.

Oversees the company’s relationships with regulatory authorities and external auditors.

Prepares recommendations for operational, strategic and policy changes as a result of external and internal audits.

Collaborates with cross-functional teams, including legal, finance and operations, to ensure alignment of compliance efforts with business objectives

Monitors regulatory developments and changes in the compliance landscape and advises company leadership accordingly.

Provides regular reporting and updates on compliance activities, issues and trends to company leadership

Acts as a champion for a culture of compliance and ethical conduct throughout the organization

Qualification

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Compliance leadershipRegulatory relationships managementAudit managementPolicy draftingCDPAP experienceMedicaid experienceMicrosoft Office proficiencyContract reviewSupervision of compliance staffGovernment contractsMedicaid