Location: Somerville,MA, USA
This is a hybrid role that will require an onsite presence at the office at Assembly Row at least 1x/month.
The Compliance Analyst is responsible for ensuring an organization's adherence to applicable laws, regulations, and industry standards. This role involves conducting research, monitoring regulatory changes, and implementing compliance programs to mitigate risks and maintain the organization's legal and ethical standing.
The Compliance Analyst is a key member of the Legal, Regulatory Affairs & Compliance Team who will provide administrative assistance, contract support and other general legal preparation matters. The compliance analyst will provide support to the compliance efforts related to health plan laws and regulations (both Federal and state). The compliance analyst will review and analyze documents to identify areas of risk and support LRAC leadership to address situation specific questions.
Principal Duties and Responsibilities:
* Stay informed about relevant government regulations, industry standards, and compliance requirements.
* Conduct ongoing research to understand the impact of regulatory changes on the organization's operations.
* Conduct review and audit of policies and procedures; recommend opportunities to strengthen the internal control structure.
* Manage LRAC matters, including preparation, organization, and maintenance of materials for board and committee meetings.
* Partner with members of the LRAC department to draft, review, assess, and edit a variety of legal documents, including service agreements, vendor agreements, contracts, NDAs, BAAs.
* Support LRAC with government affairs support and compliance obligations.
* Manage regulatory reporting for Medicaid and Commercial lines of business.
* Manage updates to organization's policies.
* As needed, assist in conducting company investigations.
* Facilitate various Committee meetings.
* Assists in data gathering and compiling information for special projects as assigned to include insurance correspondence and requests.
* Handle administrative duties as needed.
* Hold self and others accountable to meet commitments.
* Ensure diversity, equity, and inclusion are integrated as a guiding principle.
* Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
* Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
* Other duties as assigned with or without accommodation.
Qualifications:
* Bachelor's degree required or the equivalent combination of training and experience, plus five years of related experience.
* Knowledge of Medicaid regulations, HIPAA and other privacy and DOI related laws.
* Previous health plan experience preferred.
Skills/Abilities/Competencies:
* Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value.
* Bring fresh ideas forward by listening to and working with employees and the people we serve.
* Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner.
* Strong, demonstrated track record of an ability to execute on time, on budget, and on scope.
* Strong aptitude for technology-based solutions.
* Ability to inject energy, when and where it's needed.
* Current in healthcare trends.
* Demonstrated forward, visionary thinking; ability to see what is and envision what could be.
* Ability to develop, introduce, defend, and gain support for a new ideas and approaches.
* Excellent leadership skills and leadership track record.
* Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required.
* Ability to view the long-range trends and cycles of the business and industry and see the big picture.
* Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.
* Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy.
* Excellent interpersonal skills, including the ability to influence others at all levels of an organization.
* Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
* Unquestionable integrity.
About Us:
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.
We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.