- Manages Conflicts of interest, gifts entertainment, compliance ethics protocols, Code of Conduct, CCA policy procedure processes
- Prepare materials and conduct appropriate annual and ongoing corporate compliance training, education, and communication for workforce and board of directors.
- Manage and triage compliance concerns and reports received through CCA's confidential hotline.
- Conduct thorough, timely and objective compliance related investigations and partner with other areas such as Human Resource and/or Legal.
- Respond appropriately to compliance incidents and develop corrective action as needed.
- Effective management and oversight of the CCA Corporate Compliance Ethics team.
- Identify and drive improvements within the Corporate Compliance Ethics program and processes and proactively identify opportunities for risk controls, education training and/or refined guidelines and protocols.
- Oversight of Conflict of Interest (COI) program ensuring appropriate identifying, evaluating, and resolving of potential conflicts of interests.
- Manage annual compliance effectiveness survey.
- Broad and comprehensive knowledge of OIG compliance guidance on effective compliance programs, a working knowledge of healthcare laws/regulations such as Fraud Abuse, False Claims Act, Stark Law, Anti-Kickback Statute.
- Stays abreast of standards and requirements, including all relevant laws, rules and industry standards and company practices.
- Performs other duties as assigned
- Bachelor's degree
- Relevant graduate degree (e.g., Juris Doctor or master's degree in a related field)
- 5-7 years compliance ethics experience, health insurance preferred
- 3-5 years of work experience in a managerial/leadership role managing a team directly.
- Experience in designing compliance training programs.
- Proven ability to effectively and timely manage multiple initiatives and cross- departmental projects.
- Strong written, verbal, listening and communication skills - having the ability to understand and communicate appropriately to the targeted audience
- Strong supervisory/managerial skills.
- Manage staff workload appropriately and identify areas of improvement and areas for professional development for staff
- Strong analytical skills - having the ability to identify an issue, conduct an analysis to determine business impact (including gapanalyses), troubleshoot
- Strategic thinking and planning to continue to enhance the Compliance Program and the role of compliance within the organization: ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions
- Strong partnership-, relationship-, consensus- and coalition-building skills required.
- Strong emotional intelligence and self-awareness required.
- Highly consultative and partnership-oriented in approach.
- Strong program and project management skills and experience required.
- Strong ability to independently and self-sufficiently identify and navigate various operational issues.
- Strong ethical compass and integrity capital required.
- Excellent organizational, analytical and problem-solving skills, as well as oral, listening and written communication skills, required.
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Sr. Manager, Corporate Compliance - Boston, United States - Commonwealth Care Alliance
Description
Why This Role is Important to UsPosition Summary:
The Sr. Manager, Corporate Compliance Ethics manages the day-to-day activities of the corporate compliance ethics program for Commonwealth Care Alliance (CCA). The position manages CCA's Corporate Compliance Ethics programs which include Code of Conduct and corporate ethics administration; corporate investigations; compliance and ethics training, communications, education and awareness initiatives; corporate policy and procedure administration; conflict of interest administration; gifts and entertainment administration; political activities and contributions administration; and regulatory reporting.
Supervision Exercised:
Yes, which includes but is not limited to providing leadership, work direction, and performance feedback to subordinate staff.
What You'll Be Doing
Essential Duties Responsibilities:
Required Education (must have):
