The Health Connector is seeking a compliance manager to direct and manage its compliance activities. This individual will report to the General Counsel’s office, but will have significant independent responsibility to design and oversee compliance programs, and to respond to suspected incidents of non-compliance. This individual will help to develop effective policies and procedures to ensure compliance, raise employee awareness of compliance issues, and address and remediate any problems or incidents. Specific areas of compliance will include federal regulations of health insurance exchanges, state insurance laws, federal and state privacy and security requirements, and other legal requirements.
Key Responsibilities include:
- Ensuring Health Connector compliance with requirements for a public health insurance exchanges, including analysis of regulatory and statutory requirements and identification of any compliance gaps.
- Developing, initiating, maintaining, and revising policies and procedures and standards of conduct to ensure compliance and to prevent illegal, unethical, or improper conduct.
- Collaborating with other Health Connector departments (e.g., operations, policy, or financial) to direct compliance issues to appropriate channels for investigation and resolution. Consulting with in-house legal staff as needed to resolve difficult legal compliance issues.
- Collaborating with Health Connector information technology staff to implement and monitor proper data management, privacy protection, and security procedures are in place. Drafting and updating IT, data management, security and privacy policies, conducting risk assessments of privacy and security practices.
- Monitoring compliance hotlines. Investigating and acting upon any complaints or reports of suspected non-compliance, improper conduct, or waste, fraud or abuse, and/or privacy or security breaches. Developing and overseeing a system for the uniform handling of such complaints or reports.
- Ensuring that compliance issues or concerns within the organization are being appropriately evaluated, investigated and resolved.
- Identifying potential areas of compliance vulnerability and risk, and assisting in developing appropriate responses to correct or remediate problematic issues.
- In collaboration with legal staff, developing and delivering regular trainings and other activities to heighten employee awareness of employee standards of conduct, reporting obligations, and understanding of the Health Connector’s legal obligations and potential areas of risk.
- Ensuring proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
- Reporting regularly to the Health Connector executive director on the progress and operation of compliance activities.
- Procuring, managing and directing external audits of Health Connector operations, working in coordination with the Health Connector financial, legal and operations teams.
- Providing reports and updates to federal regulatory agencies on compliance activities.
- Responding to inquiries or information requests, as they occur.
Experience and Qualifications:
- A Bachelor’s degree is required.
- A minimum of two years’ experience in compliance, or legal support.
- Experience with health care, insurance, regulatory interpretation, and/or government operations strongly preferred.
- Experience or familiarity with IT system operations or data management preferred.
- Demonstrated ability to assume leadership and work independently.
- Strong ability to communicate effectively both orally and in writing.
Work Setting: This position requires the employee to work on-site in an open office setting.
Salary: Salary range is competitive; salary will be commensurate with experience.
If interested: Send cover letter and résumé to Connectoremail@example.com.
Please note: Due to the requirement of 268A, please complete the Applicant Disclosure Form and return with your application.
About the Health Connector:
The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.
The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its work force. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, gender identity, national origin or disability.