The AVP of Corporate Compliance reports to the Chief Compliance Officer and Head of Internal Audit and works with leaders across the enterprise providing guidance on all compliance related matters. The AVP of Corporate Compliance is accountable for a broad range of critical compliance activities, including ongoing program management and monitoring, improvement, investigations, policy development, facilitating compliance committee forums, oversight, liaison with internal and external customers, and reporting to senior leadership. The AVP of Corporate Compliance is a thought leader on our approach to process improvement with the intent and purpose of better serving our members. The incumbent supports the Compliance department in assessing, designing, and developing regulatory solutions that result in high quality results which meet all regulatory and contractual requirements.
Hybrid Work Schedule
- This position requires three days per week in the office at 100 Church Street, NYC (Tues / Wed / Thurs).
Duties and Responsibilities
Leadership point of contact and subject matter expert on all compliance related matters; provides guidance to leadership and the Compliance team regarding various topics and participates on teams responsible for integrating or delivering compliance requirementsEstablishes and communicates current and long-range department goals and objectives and monitors results on an ongoing basis, adjusting plans and performance expectations to achieve targeted performance improvement resultsEvaluates, develops, and recommends strategic plans aligned with the future vision of Healthfirst business excellence and Regulatory performance improvement approachesEnsures business practices are in support of all NY state and F ederal compliance, audit, and regulatory requirements, as applicableCollaborates with leadership across Compliance and the E nterprise to develop and conduct annual risk assessment for all Healthfirst lines of businessWorks across the organization to provide direction and ensure daily operations meet required schedules, and resolve critical problemsLeverages performance improvement metrics and other best practices to lead the department and embed a culture of compliance across the organizationLeads an effective team of subject matter experts through the identification, hiring and development of key talentBuilds, manages, develops, and continuously improves the department to meet the distinct and dynamic needs of a growing, evolving organizationAttends leadership meetings across the enterprise and presents key compliance metrics, results, and operational review dataIdentifies and raises high risk issues, that may impact the organization to the attention of senior business leadersOversees internal and external auditing and monitoring and advises on relevant compliance requirements, continually monitors, and improves internal and external audit and monitoring processes to ensure that the organization, including vendors, are compliant with applicable lawsIdentifies education opportunities and works with enterprise training team to implement and roll out effective training programs across the organizationMinimum Qualifications
Bachelor’s degree from an accredited institution or equivalent work experienceDemonstrated leadership of a compliance or regulatory program at a health plan, provider, law firm, state regulatory agency or consulting firmExperience communicating and influencing impact and progress to senior leadershipExperience managing a team and leading work processes in a fast-paced environmentExperience preparing and delivering information to multiple audiencesWork experience with process improvement initiativesExperience in supporting audits and regulatory requirementsExperience developing strategy and processes for a department or functionPreferred Qualifications
MBA or master's degree from an accredited institution with focus in training & development, education, business, or healthcare administrationManagement experience in an operational department within the healthcare industryPrior experience leading and managing regulatory audits with such agencies as CMS, DFS, DOH, IPRO, OMIG, OSC, and other regulatory bodiesPrior experience leading, conducting or facilitating audits at one or more of the following : commercial health insurer, Medicare Advantage, or Medicaid Managed Care organization