Job Details

Senior Compliance Specialist

Company name

Organization Type

In-House

Job Type

Attorney

Valid Through

Jan 27, 2022

Posted on

Oct 14, 2021

Years of Experience

Min 6 yrs required

Location

Lees Summit, MO, United States

Employment Type

Full-time

Industry

Legal
Practice Area
Government and Government Relations >> Government and Government Relations
Health Care >> Health Care
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Senior Compliance Specialist
The candidate's duties include: Maintain advanced-level knowledge of current and proposed compliance obligations applicable to firm’s business. Lead complex compliance change management activities, analysing new compliance obligations, providing consultative implementation support to business areas, advising on related policies and controls, and documenting how complies. Lead complex monitoring oversight, audits, and investigations to ensure firm’s ongoing compliance with relevant obligations. Lead risk assessments to identify and prioritize compliance obligations and document how complies. Review and advise on compliance monitoring activities conducted by business areas. Lead risk-based compliance audits. Lead timely investigations around potential compliance issues and risks. Engage with business areas to ensure appropriate follow up actions are completed where issues are identified. Lead the development of training and communication to reinforce a culture of compliance and ensure the workforce understands compliance expectations. Lead oversight of third-party compliance risk management processes, including collaborating with other GEHA “GRC” teams (e.g., Privacy, Enterprise Risk Management, Cybersecurity and Information Protection). Manage regulatory and licensure filing processes to ensure submissions are accurate, complete, and timely. Provide support and quality assurance for filing activities performed by other Specialists. Manage the development, maintenance, and communication for company policies in collaboration with policy business owners. Provide support and quality assurance for policy management activities performed by other Specialists.

Qualification and Experience

The candidate ‘must have a Bachelor’s degree in a relevant academic discipline; Requires 6 years of experience in compliance, legal, accreditation, or internal audit roles at a health plan or equivalent experience, with at least 3 of those years in a compliance role. Juris Doctorate or graduate degree in relevant academic discipline or may substitute for 1 year of the experience requirement; Requires highly effective verbal, written, and interpersonal communication skills across a wide range of audiences (e.g., technical staff, attorneys, senior management, auditors, regulators) for highly complex issues;Requires the ability to lead cross-functional groups, and when appropriate influence colleagues in their decision-making process; Requires advanced analytic and problem solving capabilities to identify complex issues/risks and make recommendations that effectively address business and compliance needs; Requires the ability to read and interpret complex compliance obligations (e.g., statutes, regulations, sub-regulatory guidance, contracts, accreditation requirements); Requires a self-starter personality; Requires working knowledge of Microsoft Office applications; Preferred: Extensive compliance program experience at a health plan engaged in Federal Employee Health Benefit Plan, Medicare Advantage, Medicaid, and/or highly-regulated commercial business (e.g., ACA Marketplace). Extensive subject matter expertise in statutes, regulations, and sub-regulatory guidance relating to health plans, dental plans, and dental network leasing/management companies; Extensive experience interacting with federal and/or state regulators regarding statutory/regulatory requirements, compliance issues/risks, and regulatory audits. Should have \extensive experience with federal and/or state regulators regarding health plan product and benefit filings (i.e., coverage brochures/certificates/contracts), and rate filings. Must have Juris Doctorate or Master’s degree in business, finance, health care administration, or other relevant academic discipline

Additional info

Ref : R-003164

Company info

Hiring Coordinator
Government Employees Health Association Inc
310 NE Mulberry Street
Lees Summit, MO 64086

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