Dir Corporate Compliance Assurance

Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary:  As a member of the Regulatory Compliance team, the Director, Corporate Compliance Assurance, reports to the Corporate Compliance Officer and is responsible for the development, implementation, and oversight of the compliance monitoring and auditing process.   The position supports the efforts of the Corporate Compliance Officer with the administration of the organization’s Corporate Compliance Program. The Director develops and manages the annual compliance risk assessment process and annual compliance monitoring/auditing work plan.  The role works with compliance team as part of an inter-disciplinary team to design, develop and implement new operational strategies and reports to increase operational execution and compliance with Medicare Part D regulations, applicable state/federal regulations, and other applicable requirements.  Responsibilities include connecting activities under a common compliance framework, to consolidate compliance-related data and provides management with better monitoring tools and information for decision-making.   This position relies on experience and judgment to plan and accomplish goals. 

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Directs the corporate compliance assurance team, in the development, implementation, and oversight of the annual Compliance Work Plan.  

• Oversees the initiation, progression and completion of compliance monitoring and auditing activities and escalate issues as needed. 

• Develops reporting and monitoring tools to ensure Compliance Work Plan deliverables are met, documentation is maintained, and findings/corrective actions are recorded and deliverables are met.  

• Identify areas of compliance vulnerability and risk, and assist in the development and implementation of corrective action plans.  

• In collaboration with Corporate Compliance Officer, communicate discoveries and results with executives and appropriate operational areas via executive summaries, presentations, meetings, etc.  

• Facilitate “audit-in-review” and/or global impact analysis on compliance monitoring/auditing findings to ensure compliance and to incorporate best practices into operational improvement projects. 

• Make recommendations for revisions to policies and procedures to ensure compliance with applicable laws, regulations, standards, etc.

• Create tools for the management of compliance assurance activities.  Develop Compliance 360 tool for compliance assurance tracking and reporting. 

• Provides reports and presents activities to the Corporate Compliance Officer, the Corporate Compliance Committee, and other key executives and Committees as required.

• Oversees activities related to supporting MedImpact’s and subsidiary entities various accreditations (e.g., URAC) and/or certifications.  Directs ongoing monitoring, as needed, to ensure the organization is meeting accreditation/certification standards. 

• Assists the Corporate Compliance Officer with the administration of the Corporate Compliance Program.

• Manages multiple complex projects and initiatives; performs risk assessment, defines project scope, and prioritizes initiatives.

• Interprets significance of findings, resolves issues, make recommendations and offers solutions for decisions.

Supervisory Responsibilities        

Manage assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of this unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; mentoring, planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

Qualifications

Education and/or Experience  

Bachelor’s degree required (or equivalent combination of education and experience) along with 5 – 8 plus years’ prior related experience in the PBM, healthcare, managed care or hospital industry; must have a minimum of five (5) years of leadership experience managing a team or department. Prior experience working at a PBM and/or in a compliance department highly preferred.   Previous compliance audit and monitoring experience in the job duties listed required.  Prior compliance auditing and monitoring experience in the healthcare industry highly preferred.  Project management experience a plus.  Prior accreditation (e.g., URAC, NCQA) experience preferred.  Must have in-depth knowledge of the audit function and the industry’s best practices.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed 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.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.