The majority of our roles will continue working from home until at least the end of 2021. Once it is safe to begin working onsite, employees can choose where they work - from home, in the office, or a hybrid of the two. During the interview process, our Talent Advisors will walk through our virtual-first approach and answer questions you may have.
Additional Locations:
Durham - 700
Job Description
Manages larger and more complex departmental/divisional projects and activities to ensure compliance with new and existing laws, regulations and requirements. Coordinates the day-to-day operational and tactical aspects of compliance related projects, new initiatives and other ongoing business deliverables in accordance with business needs. Identifies compliance risks and works with Corporate Compliance and other business areas as needed to develop and/or facilitate implementation of corrective action plans to mitigate risks. Conducts audits and compliance reviews to monitor ongoing compliance.
Ensure departmental/divisional compliance with existing laws, regulations and requirements by leading and supporting multifaceted and more complex cross functional activities that may impact a range of critical business processes aligned directly to key strategic initiatives.
Develop project plans and recommendations in support of Departmental/Divisional compliance objectives and leads implementation; tracks and reports on the status of the project.
Propose a variety of solutions to business issues/problems utilizing appropriate analysis tools (i.e. Cost/Benefit Analysis, Flowcharting, etc.).
Evaluate project risks, developing contingency plans and responding to change in risk as the project progresses.
Develop and tracks budgets, operating plans and financial cost forecasts to support the objectives of the project.
Collaborates closely with division team members, business owners, sponsors, and partners in the analysis, design, development, implementation, and operational support of system/process enhancements and configurations to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met.
Conduct more complex risk assessments and/or audits and monitor department/divisional systems for compliance. Ensure appropriate implementation and/or corrective action is taken to address risks and issues identified in partnership with Corporate Compliance.
Lead the analysis and assessment of the departmental environment and recommend remediation initiatives and/or compliance programming in consultation with Corporate Compliance.
Perform review of operational policies for compliance with state/federal laws and regulations and/or process improvements/efficiencies as needed.
Ensures that necessary controls are in place to monitor the effects of new functionality, and communicates status and changes to affected parties.
Manage and/or facilitate departmental/divisional implementation and remediation of compliance initiatives in conjunction with Corporate Compliance.
Develop and implement training and other communications for department personnel as needed
When working with Medicare products, coordinates departmental/divisional oversight of compliance programs and activities under the oversight of the Corporate delegated entities supporting Medicare programs.
May serve as privacy coordinator for CRPI, first point of contact and provide subject matter expertise for privacy related questions. Develop and implement corrective action plans to address identified privacy issues.
Provide direction and assistance to less experienced team members and may oversee or coordinate work efforts as needed.
Hiring Requirements
Bachelor's degree and 4 years of experience in a compliance or regulatory affairs role.
If advanced degree is held, 2 years work experience as stated above.
If no degree, 6 years work experience as stated above.
Direct project management experience with larger and more complex projects is required.
For role focused on Medicare, experience and expertise with Medicare managed care products required.
