Description and Requirements
Hybrid Work Schedule
- This position requires three days per week in the office at 100 Church Street, NYC (Tues/Wed/Thurs).
Duties and Responsibilities
Leadership point of contact and subject matter expert on all compliance related matters; provides guidance to leadership and the Compliance team regarding various topics and participates on teams responsible for integrating or delivering compliance requirements
Establishes and communicates current and long-range department goals and objectives and monitors results on an ongoing basis, adjusting plans and performance expectations to achieve targeted performance improvement results
Evaluates, develops, and recommends strategic plans aligned with the future vision of Healthfirst business excellence and Regulatory performance improvement approaches
Ensures business practices are in support of all NY state and Federal compliance, audit, and regulatory requirements, as applicable
Collaborates with leadership across Compliance and the Enterprise to develop and conduct annual risk assessment for all Healthfirst lines of business
Works across the organization to provide direction and ensure daily operations meet required schedules, and resolve critical problems
Leverages performance improvement metrics and other best practices to lead the department and embed a culture of compliance across the organization
Leads an effective team of subject matter experts through the identification, hiring and development of key talent
Builds, manages, develops, and continuously improves the department to meet the distinct and dynamic needs of a growing, evolving organization
Attends leadership meetings across the enterprise and presents key compliance metrics, results, and operational review data
Identifies and raises high risk issues, that may impact the organization to the attention of senior business leaders
Oversees internal and external auditing and monitoring and advises on relevant compliance requirements, continually monitors, and improves internal and external audit and monitoring processes to ensure that the organization, including vendors, are compliant with applicable laws
Identifies education opportunities and works with enterprise training team to implement and roll out effective training programs across the organization
Minimum Qualifications
Bachelor’s degree from an accredited institution or equivalent work experience
Demonstrated leadership of a compliance or regulatory program at a health plan, provider, law firm, state regulatory agency or consulting firm
Experience communicating and influencing impact and progress to senior leadership
Experience managing a team and leading work processes in a fast-paced environment
Experience preparing and delivering information to multiple audiences
Work experience with process improvement initiatives
Experience in supporting audits and regulatory requirements
Experience developing strategy and processes for a department or function
Preferred Qualifications
MBA or master's degree from an accredited institution with focus in training & development, education, business, or healthcare administration
Management experience in an operational department within the healthcare industry
Prior experience leading and managing regulatory audits with such agencies as CMS, DFS, DOH, IPRO, OMIG, OSC, and other regulatory bodies
Prior experience leading, conducting or facilitating audits at one or more of the following: commercial health insurer, Medicare Advantage, or Medicaid Managed Care organization
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $164,700 - $252,025
All Other Locations (within approved locations): $164,700 - $252,025
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.