Senior Director of Compliance

Compliance/Licensing  /  CAREERS
  • Req No: 2018-1447

  • Type: Regular Full-Time

  • Location: Kansas City, MO USA

Overview

Spring Venture Group is looking for a Senior Director of Compliance. This role will be responsible for the administration of SVG’s compliance program. They will oversee policies, processes, people, systems, and technology alongside partnering with business leaders to identify, mitigate and prevent compliance, regulatory and reputational risks. The Senior Director of Compliance is responsible for directing a team that addresses regulatory compliance, including HIPAA/Privacy, for insurance TeleSales related to Medicare Supplement, Medicare Advantage and Prescription Drug Plans along with other types of insurance.

Requirements

  • Manage Compliance Team including Compliance Quality and act as Privacy Officer
  • Devise, implement and oversee the Annual Compliance Work Plan and manage the Compliance Risk Assessment process to manage and continuously re-assess, revising as appropriate, SVG’s Compliance Program initiatives, including training, to ensure that all program elements are achieved in accordance with federal and state laws, rules and regulations governing compliance, Insurance Telesales and HIPAA/HiTech/Privacy
  • Facilitate risk assessment workshops with key stakeholders such as senior business unit leaders to develop strategic risk management mitigations that address specific business unit issues; Refine and/or develop tools, practices, and policies to analyze, manage, and report risks,  communicating deviations identified through monitoring to the business, and providing it with tailored remedial training and/or suggested process/procedural changes to help prevent further deviations; Ensure deviations have been remediated and managed by business owners
  • Oversees as well as develops, maintains, manages and revises policies and procedures for the general operation of SVG’s Compliance Program and its related activities to prevent non-compliant, illegal, unethical, or improper conduct
  • Oversee responses to Complaints (DOI, BBB, Carrier, etc.), detection and reporting of trends and implement corrective action plans including auditing and monitoring to remediate and mitigate concerns
  • Monitor the performance of the Compliance Program and coordinate compliance activities of other departments (including Human Resources, Sales, Information Security, Marketing, etc.) to remain aware and knowledgeable of the status of all compliance activities and to identify trends, risks, areas of improvement and corrective action plans
  • Oversee SVG’s Compliance Auditing and Monitoring efforts and conduct periodic and as-needed compliance audits and privacy impact assessments to assess regulatory compliance, privacy and data security compliance
  • Support all department’s including Marketing, Sales, Facilities, Human Resources and Information Security, Operations and Analytics teams to ensure compliance with applicable regulatory compliance, data security administrative, physical, and technical safeguards
  • Respond, investigate and report compliance concerns and inquiries, working closely with EVP, Compliance
  • Provide reports on a regular basis and promptly escalate concerns, and as directed or requested, to keep the EVP, Compliance informed of the operation and progress of compliance efforts

Qualifications

  • 7+ years’ experience managing a complex Compliance Program including Privacy within a Managed Care or related healthcare-focused organization or Insurance TeleSales
  • Attention to detail and accuracy with excellent written and oral communication skills
  • Self-starter with the ability to manage and prioritize multiple projects simultaneously, and to work across departments and businesses in a fast-paced environment
  • In-depth knowledge of Telesales, Medicare Advantage Prescription Drug Plans, Medicare Supplemental and other insurance products’ federal and state laws, rules and regulations including privacy and data security laws and regulations (HIPAA)
  • Be able to keep abreast of compliance trends and analyze regulations and industry guidance documents
  • Be able to accurately assess and communicate compliance risk as well as experience with successful Compliance Risk Assessment and Management processes and outcomes
  • Effectively present information and respond to inquiries from employees, clients, and regulators
  • Intermediate to advanced experience with IT systems and related risks with ability to implement Compliance program solutions
  • Project management experience
  • Experience interfacing directly with Managed Care Organizations and/or Insurance Carriers, state/federal agencies, investigatory bodies, Outside Counsel and legislative institutions
  • Comfortable and effective working with diverse teams, whether local or virtual
  • Sound business judgment and ability to think creatively to render practical compliance advice and solve complex business problems
  • Bachelor’s Degree required
  • Master’s degree or Law Degree and HealthCare Compliance and Privacy Certifications preferred
  • Great sense of humor and passionate about your work

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