- Lead the development, implementation, and management of an enterprise-wide compliance program, including policy and process development, establish and maintain effective training programs, communication of compliance issues and advise on risk assessment and management.
- Develop and implement compliance strategies and programs to ensure compliance with healthcare laws, regulations, and ethical standards both federally and statewide.
- Coordinate in collaboration with business leaders, compliance functions for federal and state health care programs such as those originating from Centers for Medicare and Medicare (CMS) programs, such as the ACO REACH program, MSSP and state health care programs such as New York State Health Home.
- Oversee and manage compliance activities across the organization, including policy development, training, and monitoring.
- Conduct internal audits and investigations to identify and address compliance issues and risks.
- Track and report results of compliance investigations and the corrective actions taken to internal key stakeholders as needed. Interpret findings and/trends and carry out corrective action and
- Collaborate with cross-functional teams to integrate compliance within the business to address risks and noncompliance, including recommending and taking corrective actions when needed.
- Provide leadership and guidance to compliance functions and operations within the organization, fostering a culture of compliance throughout the organization.
- Advise senior management on compliance metrics and present and compliance updates recommendations.
- Stay current on changes in healthcare laws and regulations and provide guidance regarding.
- Serve and be identified as the Compliance Officer for the organization.
- Conduct annual compliance and fraud, waste, and abuse (FWA) risk assessment, and develop a risk remediation plan.
- Ensure organizational adherence to HIPAA and state privacy laws and regulations.
- Perform other job-related duties as assigned.
- Leadership: The Vice President of Enterprise-Wide Compliance will lead in defining and executing strategies and solutions to create business value in compliance, including building a team to design, develop, and execute those strategies and solutions to deliver desired outcomes.
- Strategy: The Vice President of Enterprise-Wide Compliance will establish the business strategy and roadmap: (1) improve outcomes for CINQCARE members, who CINQCARE refers to as Family Members; (2) enhance the efficacy of other CINQCARE. business divisions; and (3) develop and deliver external market opportunities for CINQCARE products and services. In establishing the business strategy, the VP of Compliance will define and innovate sustainable revenue models to drive profitability of the Company.
- Collaboration: The Vice President of Enterprise-Wide Compliance will ensure that compliance capabilities form a cohesive offering, including by working closely with other business divisions to learn their needs, internalize their knowledge, and define solutions to achieve the business objectives of CINQCARE.
- Knowledge: The Vice President of Enterprise-Wide Compliance will provide subject matter expertise in compliance solutions, including determining and recommended approaches for ensuring organizational adherence to HIPAA and state privacy laws and regulations, solution deployment, and performance evaluation.
- Culture: The Vice President of Enterprise-Wide Compliance is accountable for creating a productive, collaborative, safe and inclusive work environment for the compliance team and as part of the larger Company.
- Education: Minimum of Bachelor's degree with a record of strong academic achievement. Graduate or Juris Doctorate preferred;
- Experience: A minimum of 9 years of working knowledge and previous experience in compliance in the healthcare industry.
- Knowledge of Federal and State laws and regulations governing health care and insurance. Including Medicare and Medicaid, as well as state law programs.
- Experience functioning as Compliance lead, e.g. in IPA, ACO, MSO, and MCO settings and federal or state governments.
- Knowledge of Centers for Medicare & Medicaid Services (CMS) regulations, particularly for ACO REACH Program.
- Demonstrated ability to create and implement a vision, strategy, and plan that meets compliance standards for CINQCARE.
- Proficient in collecting and analyzing compliance business processes, workflows, and control relationships.
- Entrepreneurial: CINQCARE seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring CINQCARE is positioned to innovatively deliver on its promise.
- Communication: Excellent verbal, written communication and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQCARE's team, investors, partners, and other stakeholders. Proficiency in all Microsoft Office applications.
- Relationships: Ability to build and effectively manage relationships with business leaders and external constituents; and,
- Culture: Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company.
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Vice President of Enterprise - Washington, United States - CINQCARE
Description
CINQCAREVice President of Enterprise-Wide Compliance
Position Description
Overview
The Vice President of Enterprise-Wide Compliance reports to the Chief Legal with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE's core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don't have patients or customers - we have Family Members.
Job Responsibilities
The Vice President of Enterprise-Wide Compliance will have the following responsibilities:
The Vice President of Enterprise-Wide Compliance will have the following duties:
The Vice President of Enterprise-Wide Compliance should have the following qualifications:
Compensation: $170,000 - $210,000
