Job Details

Director Of State And Usfhp Compliance

Company name


Organization Type

Public Interest

Job Type

Non-practicing Attorney

Date Last Verified

Mar 19,2019

Valid Through

Jul 02,2019

Posted on

Mar 14,2019

Years of Experience

Min 10 yrs required


Irving, TX, United States

Employment Type



Practice Area
Health Care >> Health Care
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Director of State and USFHP Compliance
The candidate will supervise and manage the selection, training, development, appraisal, and work assignments of team associates. Instill a high performance culture in the team with a focus on team work, service excellence and ownership for resolving issues. Set standards for and complete evaluations of direct reports. Set standards for and complete evaluations of direct reports. Submit daily, weekly, monthly, quarterly and annual reports as requested and as per contract and regulatory specifications. Ensure compliance procedures and practices are well defined, documented and consistently applied. Interfaces with compliance oversight committees, regional and entity leadership, legal counsel, and other related parties to represent the organization's interests with external parties (state or local government agencies) who adopt or amend legislation, regulations, or standards. Implement and execute auditing, monitoring, tracking, and reporting to ensure the success of the health plan compliance program. Ensure that systemic processes are in place to address and mitigate compliance risks and identified issues. Serves as a product manager liasion between the health plan and the Defense Health Agency. Reviews rules to insure compliance with requirements. Communicates to operational leaders the compliance implications of existing and new laws and regulations as they pertain to various CHP entities. Works closely with legal counsel to ensure proper interpretation of the applicable laws and regulations. Responsible for coordinated and tracking external regulatory oversight audits. Ensures department's compliance with DoD, CMS/CCIIO, TDI, OSI, LDI and other applicable regulatory, NCQA and URAC standards, including the Health Insurance Exchange. Initiates remediation and corrective action plans when compliance deficiencies are identified. Collaborate with all other departments as appropriate and required to facilitate the completion of required regulatory reports. Reviews the submission of data to regulatory bodies to ensure that it is accurate and in compliance with reporting requirements. Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability ACT (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). Should have Bachelor's Degree Business Administration, Healthcare Administration or exemplary experience. J.D. degree preferred. Must have 10+ years of substantive health plan experience, with increasingly progressive responsibility. Compliance experience strongly preferred.

Additional info

Job ID: 5000470250906

Company info

Hiring Coordinator
Las Colinas Corporate Center II
6363 North Highway 161,Suite 450
Irving, TX 75038