AVP, Corporate Compliance

Description and Requirements

The AVP of Corporate Compliance reports to the Chief Compliance Officer and Head of Internal Audit and works with leaders across the enterprise providing guidance on all compliance related matters. The AVP of Corporate Compliance is accountable for a broad range of critical compliance activities, including ongoing program management and monitoring, improvement, investigations, policy development, facilitating compliance committee forums, oversight, liaison with internal and external customers, and reporting to senior leadership. The AVP of Corporate Compliance is a thought leader on our approach to process improvement with the intent and purpose of better serving our members. The incumbent supports the Compliance department in assessing, designing, and developing regulatory solutions that result in high quality results which meet all regulatory and contractual requirements.

Hybrid Work Schedule

• This position requires three days per week in the office at 100 Church Street, NYC (Tues/Wed/Thurs).

• 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

• 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

• 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