Description and Requirements
Hybrid Work Schedule/b>/u>/p> /p> Duties and Responsibilities/span>/b>/u>/p>/div> Leadership point of contact and subject matter expert on all compliance related matters; provides guidance to leadership and the/span> /span>Compliance team regarding /span>various topics/span> and /span>participates/span> on teams responsible for integrating or delivering compliance requirements/span>/span>/p>/li> Establishes and communicates current and long-range department goals and /span>objectives/span> and monitors results on an ongoing basis,/span> /span>adjusting plans and performance expectations to achieve targeted performance improvement results/span>/span>/p>/li> Evaluates, develops, and recommends strategic plans aligned with the future vision of Healthfirst business excellence and Regulatory/span> /span>performance improvement approaches/span>/span>/p>/li> Ensures business practices are in support of all NY state and /span>/span>F/span>/span>/u>ederal compliance, audit, and regulatory requirements, as applicable/span>/span>/p>/li> Collaborates with leadership across Compliance and the /span>/span>E/span>/span>/u>nterprise to develop and conduct annual risk assessment for all Healthfirst/span> /span>lines of business/span>/span>/p>/li> Works across the organization to provide direction and ensure daily operations meet required schedules, and resolve critical problems/span>/span>/p>/li> Leverages performance improvement metrics and other best practices to lead the department and embed a culture of compliance across/span> /span>the organization/span>/span>/p>/li> Leads an effective team of subject matter experts through the identification, hiring and development of key /span>talent/span>/span>/p>/li> Builds, manages, develops, and continuously improves the department to meet the distinct and dynamic needs of a growing, evolving/span> /span>organization/span>/span>/p>/li> Attends leadership meetings across the enterprise and present/span>s/span> key compliance metrics, results, and operational review data/span>/span>/p>/li> Identifies and raises /span>high risk/span> issues, that/span>/span> may /span>impact/span> the/span> organization/span> /span>to the attention of senior business leaders/span>/span>/p>/li> Oversees internal and external auditing and monitoring and advises on relevant compliance requirements, continually /span>monitors/span>, and/span> /span>improves internal and external audit and monitoring processes to ensure that the organization, /span>including /span>vendors, are compliant with/span> /span>applicable laws/span>/span>/p>/li> Identifies education opportunities and works with enterprise training /span>team/span> to implement and roll out/span> effective training programs /span>across the organization/span>/span> /span>/p>/li>/ul>/div> /span>/p>/div> Minimum Qualifications/span>/b>/u>/p>/div> Bachelor’s degree from an accredited institution or equivalent work experience/span>/span>/p>/li> Demonstrated leadership of a compliance or regulatory program at a health plan, provider, law firm, state regulatory /span>agency/span> or consulting/span> /span>firm/span>/span>/p>/li> Experience communicating and influencing impact and progress to senior leadership/span>/span>/p>/li> Experience managing a team and leading work processes in a fast-paced environment/span>/span>/p>/li> Experience preparing and delivering information to multiple /span>audiences/span>/span>/p>/li> Work experience with process improvement initiatives/span>/span>/p>/li> Experience in supporting audits and regulatory requirements/span>/span>/p>/li> Experience developing strategy and processes for a department or function/span>/span>/p>/li>/ul>/div> /p> Preferred Qualifications/span>/b>/u>/p>/div> MBA or master's degree from an accredited institution with focus in training & development, education, business, or healthcare/span> /span>administration/span>/span>/p>/li> Management experience in an operational department within the healthcare industry/span>/span>/p>/li> Prior experience leading and managing regulatory audits with such agencies as CMS, DFS, DOH, IPRO, OMIG, OSC, and other/span> /span>regulatory bodies/span>/span>/p>/li> Prior experience leading, conducting or /span>facilitating/span> audits at one or more of the following: commercial health insurer, Medicare Advantage,/span> /span>or Medicaid Managed Care organization/span>/span> /span>/p>/li>/ul>/div> /span>/p>/div>/div>
Hiring Range*:/p> Greater New York City Area (NY, NJ, CT residents): $168,900 - $258,400/p>/li> All Other Locations (within approved locations): $168,900 - $258,400/p>/li>/ul> As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision./p> In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live./p> *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role./i>/p>