Director, Compliance

Compliance Director

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of healthcare. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Responsible for leading the MedImpact Health & Wellness ("MH&W") Compliance Program, including providing support of the HIPAA compliance program with a focus on privacy and security. Manages and oversees regulatory compliance activities to ensure that MH&W services are provided in accord with applicable laws, regulations, and accreditation standards pertaining to applicable federal and state regulatory and licensure requirements. This position manages requests from vendors, clients, regulatory authorities, MH&W subsidiaries, and internal customers relating to MH&W regulatory compliance initiatives, licensing, and related processes. Relies on experience and judgment to plan and accomplish goals.

Essential duties and responsibilities include the following. Other duties may be assigned.

• Independently and in collaboration with the General Manager, and HIPAA Privacy & Security Officer addresses compliance matters related to MH&W and subsidiary entities. The Director ensures company HIPAA policies and procedures are appropriate to meet HIPAA and ERISA requirements and identifies operational opportunities and obstacles for the Director and their team to work with other departments to ensure the company and their employees and customers are in compliance with all relevant regulations.
• Research applicable state and federal laws and agency regulations. Tracks applicable legislation / regulations, analyzes impact on company and subsidiaries, and communicates relevant information to the organization, with minimal management supervision. Works with outside legal counsel and other 3rd party consultants as needed to ensure compliance and review of relevant policies, health plans, and insurance policies and procedures. Keeps apprised of new regulatory developments by reviewing regulatory publications and applicable industry trade publications. Monitors and keeps up to date on assigned state's changing healthcare regulations, legal requirements, or pending legislation.
• Obtains, maintains and reviews new licenses, licensing renewals, and reporting requirements for regulatory changes and updates. Participates in MH&W subsidiary licensing oversight efforts. The Director will be considered the company expert for compliance matters.
• Interfaces with regulatory authorities on matters relating to compliance with applicable laws or regulations, and prepares proposed policy or practice corrections as needed in response to negative findings of regulatory agencies. The Director will prepare any supporting evidence or documentation related to both legal and regulatory requests for information or in response to due diligence performed for legal disputes or regulatory requests for information.
• Responsible for writing applicable regulatory compliance policy and procedure documentation and for obtaining necessary company approvals related to the new or revised policies. The Director is also responsible for the dissemination of the policies and changes to the policies with the various operating units.
• Directs the assigned corporate state filings for subsidiaries and affiliate entities to include, but not limited to, submission of required documents, ensuring invoices are paid, and submission of license applications and renewals. Actively maintains and manages corporate records for corporations, subsidiaries, and, as required, affiliate entities, including tracking ownership information, qualified jurisdictions, board / manager information, etc. The Director will Collaborate and consult with various department management as needed to ensure the company and its subsidiaries are in compliance with all relevant laws and regulations.
• Serves as the administrator for vendors and the associated tools used by the Compliance Department. The Director will ensure training needs and instructions for departments, subsidiaries, and affiliate entities, as needed, on vendor tools. Handles ongoing oversight of Compliance vendors, including vetting current and potential vendors. Works with the Contracting department on compliance vendor contracting needs. Ensure appropriate documentation is maintained on Compliance vendors to ensure appropriate management is in place.
• Directs the Corporate Compliance Program reporting to the Vice President or General Manager as determined by the GM of MedImpact Health and Wellness.
• Identifies needs and participates in internal workgroup compliance initiatives to Direct, advise and assist company compliance implementation efforts. Facilitate inter-departmental meetings as needed.
• Maintains expertise in assigned research topic(s) to support identified company compliance needs.
• Monitors and advises on company practices and documentation related to regulatory compliance.
• Independently and accurately assesses and responds to internal and external requests and responds to complaints from external customers (clients, vendors, regulatory agencies, etc.).
• Acts as an internal liaison to support regulatory audits. Facilitates and handles regulatory audits on behalf of the department for external clients.
• Directs assigned projects by planning, researching, and auditing deliverables. Assigns or delegates projects or tasks as appropriate, directing the activities of the department.
• Reads, analyzes, and interprets contracts and legal documents. Advises company on contractual issues and concerns.
• Directs, mentors, assists, and coaches less experienced Regulatory Compliance personnel.

Supervisory Responsibilities

Manages assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening / verbal / written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience

BA / BS Degree or equivalent; plus 10 years' related experience; 10 years of SME in respective area(s); (or equivalent combination of education and experience); and 8 years supervisory experience; Supervisory experience may be substituted with 10 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader at the Director level or above that must be completed within 12 months in new position.

Computer Skills

To perform this job successfully, an individual should have expert skills of Microsoft Office Suite, especially Excel, Word, and PowerPoint.

Other Skills and Abilities

Reasoning Ability

Mathematical Skills

Language Skills

Competencies