Health Care Attorney in Boston, MA

Profile

VP of Compliance The candidate will ensure regulatory compliance with state and other government agencies corporate and business subsidiaries. Will develop strategic relationships with state legislative policymakers and assisting with the development of state legislative public policy. Maintain and track laws and regulations, contract documentation, amendments, and various compliance measures. Develop policies, procedures, and processes to comply with state law, federal law, contract requirements, and other standards. Oversee, administer, and implement various compliance programs, including fraud and abuse and HIPAA. Provide guidance to all departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language. Conduct compliance audits, develop and implement corrective action plans, and report on achievement of action plans to senior management and Board of Directors. Identify, evaluate and analyze the impact of state legislative and regulatory issues and advise management regarding the impact on the plan.

Qualification and Experience

The candidate should have a Bachelor's degree in a related field. Master's or Law degree is a plus. Must have 8+ years of compliance program management and contract experience. Extensive knowledge of state administrative code and regulations, state insurance laws and regulations including managed care regulations required. Experience with state and federal government agencies, accreditation bodies, participating provider agreements, HIPAA and TPA laws, credentialing regulations and prompt pay laws is needed.

Company info