Director, Compliance

Location: Jacksonville, Florida US

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Job Number: 4776

Position Title: Director, Compliance

External Description:

Position Summary:

Alignment Health and its affiliates and subsidiaries, including Alignment Health Plan, (AHC) are committed to maintaining an effective compliance program for promoting compliance with laws, regulations and company conduct requirements that govern operation of the organization.  The Director of Compliance and Regulatory Affairs (“Compliance Director”) is part of the management team responsible for the day-to-day operation of the AHC Compliance Program and reports directly to the Associate Vice President of Compliance and Regulatory Affairs.

 

This Compliance Director is a leader and regulatory subject matter expert, joining enterprise-wide projects to achieve business operational excellence and compliance with all measures relative to State and Federal Compliance and HIPAA initiatives.  The Compliance Director will immediately educate himself/herself on any new applicable State and Federal regulations and provide guidance and interpretation of new regulations throughout the organization to ensure the executives, management, employees and contractors are educated on these requirements.

General Duties/Responsibilities (May include but are not limited to):

  1. Direct, coordinate, and monitor efforts to ensure operational compliance with (a) applicable federal and state laws and regulations, (b) CMS contract and Part C and Part D Program requirements, (c) Compliance Department and operational policies and procedures as they relate to compliance, and (d) the Alignment standards of conduct requirements.
  2. Provide reports to the Associate Vice President of Compliance and Regulatory Affairs and the Operational Compliance Committee on a regular basis, and as directed or requested, to keep the AHC Board members and Executive Management informed of the operation of progress of compliance efforts.
  3. Respond to alleged violations of rules, regulations, policies, procedures and Standards of Conduct by initiating investigative procedures, including developing and overseeing a system for uniform handling of such violations.
  4. Assist in defining the compliance program structure, educational requirements, reporting, and complaint mechanisms, response and correction procedures, and compliance expectations of all personnel and FDRs.
  5. Institute effective compliance activities through an efficient use of resources and a focus, in conjunction with Senior Managers, on continuous performance improvement initiatives designed to maximize compliance; and
  6. Embody and promote an overall culture of compliance that encourages ethical conduct and a commitment to compliance with the law.

Supervisory Responsibilities:

Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1.       Minimum Experience:

    1. Understanding of the Medicare MA/Part D Program, and executing the duties and responsibilities set forth in the AHC Compliance Program.
    2. 5 years experience in a healthcare organization
    3. 3 years in a leadership role

2.       Education/Licensure:

a.       Bachelor’s degree and/or equivalent experience and education

b.       CHC, CCEP or similar Compliance training certification (optional)

3.       Other:

a.       Experience in facilitating and managing across teams and managing projects.

b.       Likes to focus on the "big picture" and thrives in a fast paced, multi-project work environment.

c.       Proficient in Microsoft Office (Word, PowerPoint, Excel).

d.       Excellent communication skills, both oral and written.

  1. Work Environment
    1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

5.       While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

6.       The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Health, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

City: Jacksonville

State: Florida

Location City: Jacksonville

Location State: Florida

Community / Marketing Title: Director, Compliance

Company Profile:

Alignment Health was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Health team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

EEO Employer Verbiage:

Alignment requires all new hires to follow local and/or state requirements regarding the COVID-19 vaccine and booster.  If applicable, proof of vaccination and booster will be required as a condition of employment subject to legal exemptions.  This policy, which Alignment reserves the right to modify, is part of Alignment’s ongoing efforts to ensure the safety and well-being of its staff and community and to support public health efforts.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].