Director, Compliance

August 14

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Ancillary Employee Benefits • Digital and Mobile Health • Software • Consumer Packaged Goods

201 - 500

Description

• Create and manage strategy for the Compliance department; • Educate and develop a team of highly motivated managers and analysts; • Present to the Senior Leadership Team regarding compliance initiatives and risks; • Perform cross-functional compliance initiatives including compliance risk assessments; • Communicate regulatory requirements to internal and external clients; • Partner with business stakeholders to develop, implement, and maintain written compliance policies and procedures; • Draft, implement, and train on policies and procedures owned by compliance; • Assist with regulatory compliance issues including the identification, tracking, assessment, and execution of mitigating action plans; • Assist with the complaints process, including but not limited to, tracking, investigation and response, and reporting internally and externally; • Perform risk-based periodic compliance monitoring and testing; • Respond to ad-hoc compliance requests from various internal and external partners, including the creation of action plans in response to regulatory changes; • Collaborate cross-functionally with various business teams including sales, support, service, business development, IT, and finance; • Maintain annual compliance training for the business; • Review, analyze, and interpret licensing laws and regulations; • Review and approval of marketing and advertising materials for all insurance products, including dental, vision, life, and disability; • Provide Compliance expertise for new programs and processes (i.e., campaigns, promotions, system enhancements); • Assist and provide guidance to the business regarding state dental network compliance; • Assist Legal with reviewing employee conflict of interest submissions; • Perform vendor due diligence reviews; • Ensure adherence and compliance with external partners administrative guidelines; • Assist in the review of potential fraud cases within the business; • Implement changes in insurance licensing requirements based on changes in laws, regulations, company policies, and/or company products and/or services; • Other duties as assigned

Requirements

• Minimum of 7 years of compliance or legal experience, preferably within the insurance industry • Strong understanding of federal and state healthcare laws and regulations • In-depth knowledge of HIPAA and state-specific privacy laws is highly desirable • Proven experience conducting both third-party and internal audits • Strong leadership skills • Excellent oral and written communication skills for contact with internal and external stakeholders, including but not limited to regulatory agencies • Demonstrated ability to work independently, self-starter and highly motivated • Excellent ability to investigate, analyze, and interpret data and regulatory law • Organizational and project management skills • Able to interface with key stakeholders to execute regulatory changes • Ability to identify gaps and drive solutions