Sr. Manager, Corporate Compliance & Ethics

Position Summary

Why This Role is Important to Us:

The Sr. Manager, Corporate Compliance & Ethics manages the day-to-day activities of the corporate compliance & ethics program for Commonwealth Care Alliance (CCA). The position manages CCA’s Corporate Compliance & Ethics programs which include Code of Conduct and corporate ethics administration; corporate investigations; compliance and ethics training, communications, education and awareness initiatives; corporate policy and procedure administration; conflict of interest administration; gifts and entertainment administration; political activities and contributions administration; and regulatory reporting.



Supervision Exercised

Yes, which includes but is not limited to providing leadership, work direction, and performance feedback to subordinate staff.



What You'll Be Doing



Essential Duties & Responsibilities:

• Manages Conflicts of interest, gifts & entertainment, compliance & ethics protocols, Code of Conduct, CCA policy & procedure processes
• Prepare materials and conduct appropriate annual and ongoing corporate compliance training, education, and communication for workforce and board of directors.
• Manage and triage compliance concerns and reports received through CCA’s confidential hotline.
• Conduct thorough, timely and objective compliance related investigations and partner with other areas such as Human Resource and/or Legal.
• Respond appropriately to compliance incidents and develop corrective action as needed.
• Effective management and oversight of the CCA Corporate Compliance & Ethics team.
• Identify and drive improvements within the Corporate Compliance & Ethics program and processes and proactively identify opportunities for risk controls, education & training and/or refined guidelines and protocols.
• Oversight of Conflict of Interest (COI) program ensuring appropriate identifying, evaluating, and resolving of potential conflicts of interests.
• Manage annual compliance effectiveness survey.
• Broad and comprehensive knowledge of OIG compliance guidance on effective compliance programs, a working knowledge of healthcare laws/regulations such as Fraud & Abuse, False Claims Act, Stark Law, & Anti-Kickback Statute.
• Stays abreast of standards and requirements, including all relevant laws, rules and industry standards and company practices.
• Performs other duties as assigned
  
  
  
  

What We're Looking For



Required Education (must have):

• Bachelor’s degree
  
  
  
  

Desired Education (nice To Have)

• Relevant graduate degree (e.g., Juris Doctor or master’s degree in a related field)
  
  
  
  

Required Experience (must Have)

• 5-7 years compliance & ethics experience, health insurance preferred
• 3-5 years of work experience in a managerial/leadership role managing a team directly.
• Experience in designing compliance training programs.
• Proven ability to effectively and timely manage multiple initiatives and cross- departmental projects.
  
  
  
  

Required Knowledge, Skills & Abilities (must Have)

• Strong written, verbal, listening and communication skills – having the ability to understand and communicate appropriately to the targeted audience
• Strong supervisory/managerial skills.
• Manage staff workload appropriately and identify areas of improvement and areas for professional development for staff
• Strong analytical skills – having the ability to identify an issue, conduct an analysis to determine business impact (including gapanalyses), troubleshoot
• Strategic thinking and planning to continue to enhance the Compliance Program and the role of compliance within the organization: ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions
• Strong partnership-, relationship-, consensus- and coalition-building skills required.
• Strong emotional intelligence and self-awareness required.
• Highly consultative and partnership-oriented in approach.
• Strong program and project management skills and experience required.
• Strong ability to independently and self-sufficiently identify and navigate various operational issues.
• Strong ethical compass and integrity capital required.
• Excellent organizational, analytical and problem-solving skills, as well as oral, listening and written communication skills, required.