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VP Compliance

  • Job type: Permanent
  • Location: Manchester, New Hampshire
  • Salary: US$185000 - US$200000 per year
  • Job reference: 280811/001_1551807005
  • Sector: Compliance, Selby Jennings
  • Date posted: 05/03/2019

*This Position will be located in one of The Firm's nationwide offices, with expected nationwide travel.

This position establishes control points and adherence to all state health insurance and CMS exchange regulations while optimizing The Firm's professional relationships with CMS and other key stakeholders. This position reports to Chief Compliance Officer. The Commercial and Specialty businesses generate several billion dollars in revenue annually and helps provide valuable medical and specialty coverage to millions of individuals, groups and employers. As a critical partner in health care delivery, the risks of failing to maintain compliance could result in fines, sanctions and/or termination of contracts and licenses.

Responsible For:

  • Implement the Commercial and Specialty Compliance Programs. The Commercial and Specialty Compliance Officer is accountable for defining the Commercial and Specialty Compliance Program structure, educational requirements, reporting, and compliance expectations of all personnel and vendors supporting The Firm's Commercial and Specialty businesses (including life, disability, vision, dental).

  • Ensure compliance reports are provided regularly (at least quarterly) to the Board or sub-committee of the Board (i.e., Audit Committee), divisional Presidents overseeing Commercial and Specialty, and the Commercial and Specialty Compliance Committee.

  • Develop and implement methods and programs that encourage managers, employees, and vendors to report noncompliance and potential FWA without fear of retaliation

  • Oversee the development and monitoring of the implementation of corrective action plans

  • Interview or delegate the responsibility to interview employees, vendors and other relevant individuals regarding compliance issues

  • Review company contracts and other documents pertinent to the Commercial and Specialty business Review or delegate the responsibility to review the submission of data to CMS to ensure that it is accurate and in compliance with CMS reporting requirements;

  • Conduct and/or direct audits or monitoring of any area or function involved with Commercial and Specialty business; and

  • Recommend policy, procedure, and process changes


Qualifications:

  • Minimum of 10-15+ years of experience in large, corporate healthcare

  • Bachelor's degree in a related field (Master's preferred)

  • Demonstrated experience managing an enterprise-wide relationship with regulators and senior leaders

  • Minimum of 8 years of experience managing a compliance or governance function in a complex health care environment

  • Demonstrated successful leadership skills in program management, program execution, and people management

  • Ability to plan, organize, administer, and coordinate a variety of large and complex services, projects, and programs

  • Successful leadership and management experience building effective teams, managing cross functional teams, and continuous improvement/staff development