Summary Description: Under the direction of the assigned management, this position assesses new and existing regulatory, ethics and/or privacy issues to determine implications and develops practical solutions as issues are identified. Executes and manages compliance and/or governance matters through implementation. Assesses compliance through various methods including auditing and monitoring, inclusive of assigned audits and monitoring, privacy and/or governance vulnerabilities, conducts root-cause analysis, and recommends, initiates and oversees process improvement activities. Identifies compliance and/or governance best practice opportunities, recommends process refinements, brings practical improvements to implementation and produces policy recommendations. This position provides oversight and management of regulatory, governance, ethics and/or privacy requirements, implementing and monitoring for compliance performance to meet corporate goals. Essential Resource Responsibilities / Accountabilities:
- Assesses the business impact for state and federal regulations and mandates.
- Works directly with business area staff, Compliance Oversight Committee and Legal Counsel to define and document requirements for implementation.
- Researches, interprets and communicates regulation requirements to internal customers. Provides and supports training or reference materials as appropriate.
- Independently facilitates, establishes, manages and monitors work teams to successfully implement requirements in operation areas.
- Develops and executes compliance communication tools and training and monitoring programs to ensure continued compliance.
- Assesses potential non-compliance vulnerabilities, identifies root causes of issues and provides practical business recommendations for corrections. Works with business area ambassadors to develop recommendations and reach meaningful and appropriate resolutions.
- Develops and manages analysis to promote and ensure compliance across the corporation
- Develops, maintains and analyzes Compliance reports including those related to regulatory commitments, Ad Hoc Corporate issues and all general compliance issues.
- Initiates and executes long and short-range planning processes and schedule resources required to meet plans and objectives.
- Identifies the level of support required within areas of responsibility.
- Effectively communicates ethics, privacy, and compliance policies, procedures and practices to all employees, Boards of Directors and other agents through publications, training and educational programs.
- Develops and implements communication vehicles to address expectations of employee behavior.
- Serves as technical expert in the design, development and delivery of employee education and training programs regarding compliance with applicable laws, regulations and the code of conduct.
- Provides expert advice and interpretation of the Code of Conduct, Conflict of Interest, Ethics and Privacy including the applicability of corporate policies and procedures to specific situations for employees and Boards of Directors.
- Effectively leads and manages Ethics, Privacy, Governance and Compliance initiatives and projects.
- Develops reports, prepare and assure accuracy of information provided to outside counsel to support annual filings to regulators and other requests from regulators as received.
- Plans, performs fieldwork, reporting and following up on specific audit assignments.
- Maintains strict confidentiality related to matters of the corporations and Boards of Directors.
Minimum Resource Qualifications:
- Bachelors degree in related area with a minimum of five years related experience or compliance training. In lieu of degree, a minimum of nine years in health insurance or health care delivery.
- Knowledge of corporate operations, corporate goals and objectives and the organizations structure.
- Extensive knowledge of regulatory initiatives and legislation that impacts the Corporation.
- Excellent written and verbal communication skills.
- Strong analytical and organizational skills and ability to manage multiple projects simultaneously with minimal management directive.
- Excellent PC skills including Word, Excel, Access and Lotus Notes.
- Proven project management/implementation skills required.
- Understands regulations and can administer compliance for all areas across the organization.
- Must be able to follow up on customer inquiries promptly and accurately. Act with a sense of urgency (importance, purpose, and drive).
- Demonstrated experience in taking ownership of issues and follow through to resolve them.
- Exceptional verbal and written communication and ability to collaborate across the organization.
- Willingly adapts to effect change efficiently and smoothly.
Physical Requirements: In support of the Americans with Disabilities Act, this resource requirements document lists only those responsibilities and qualifications deemed essential to the position Equal Opportunity Employer: Equal Opportunity Employer. As such, requires all suppliers of temporary staffing resources to affirm the rights of every person to participate in all aspects of employment without regard to race, color, sex/gender, age, disability, religion, creed, citizenship status, national origin, veteran status, military status, marital status, familial status, domestic violence victim status, sexual orientation, gender identity, predisposing genetic characteristic, genetic information, or any other status protected under the law