Compliance Risk Manager (Remote Option)
Partners Health Management
2 reviews
Kannapolis, NC 28081
Remote
Full-time
Partners Health Management
2 reviews
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Job details
Job Type
Full-time
Remote
Benefits
Pulled from the full job description
401(k)
401(k) matching
Dental insurance
Disability insurance
Health insurance
Vision insurance
Indeed's salary guide • Not provided by employer
• $78K - $98.8K a year is Indeed's estimated salary for this role in Kannapolis, NC.
Full Job Description Competitive Compensation & Benefits Package! Position eligible for –
• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
See attachment for additional details.
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Office Location: * Flexible for any of our office locations; Remote Option Available for Right Candidate
Projected Hiring Range: Depending on Experience
Closing Date: Open Until Filled
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Primary Purpose of Position: *
The Compliance Risk Manager is responsible for managing the organization’s Vendor Oversight Program as well as Compliance Risk Management. This position ensures effective vendor risk management, Service Level Agreement (SLA) Risk Management, and other compliance related risk management for the overall organization as delegated. This position is vital to protecting, mitigating, reducing and resolving risk (financial, regulatory, and/or reputational) to the organization.
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Role and Responsibilities: *
• Assists with the onboarding and offboarding of key vendors to ensure effective compliance with regulatory and contractual requirements are clearly outlined and met.
• Develops, implements and manages the Vendor Oversight Program
• Develops and manages the compliance risk management program.
• Uses data and other resources to anticipate, monitor and mitigate potential risks to the organization for non-compliance
• Oversees the collective management and compliance with all NCDHHS service level agreements (SLAs) across the organization. Ensuring SLAs are delivered according to specifications and that the organization maintains compliance with SLA standards.
• This position works closely with business units within the organization as well as key partners who may perform SLA related services on behalf of the organization and shall be proficient in collaboration, team building, negotiation, and conflict management and resolution
• Develops processes to monitor and audit ongoing compliance with SLAs with the objective of meeting compliance with all SLAs and avoiding any potential for liquidated damages as a result of non-compliance
• Works collaboratively with business partners to ensure compliance and proactive risk identification and mitigation processes are in place and effective.
• Collaborates with QM and appropriate business units on the identification of improvement opportunities and actively participates in improvement opportunities as it relates to ensuring ongoing compliance and risk mitigation.
• Manages any compliance risk management corrective action plans, reporting and resolution. Provides a structure for the formation and implementation of corrective measures
• Performs gap analysis to highlight risks related non-compliance, investigating reasons and recommending actions to prevent recurrence
• Ensures the expectations of the SLAs, vendor oversight and related compliance risk management are clear and unambiguous, working with key business units to identify any related performance metric definition or related criteria concerns are identified and addressed
• Serves as an active member of the Regulatory Compliance Committee (RCC) and other committees/workgroups as designated
• Ensures controls are in place to identify, review, monitor and manage compliance
• Works with cross-functional subject matter experts (SMEs) across the organization to ensure effective communication and coordination of oversight practices to avoid duplication and maximize efficiencies
• Manages vendor performance data, Service Level Agreement (SLA) performance data and other designated compliance/risk management information as well as reporting across the organization, working with Business Owners to ensure compliance. Establishes and manages an organizational dashboard for both vendor oversight as well as SLA performance to meet organizational needs and ensure visibility, awareness and mitigation of areas of risk.
• Ensures business departments understand the ongoing oversight responsibilities of delegates/vendors and are prepared to partner with vendor management to monitor specific functions and performance at the SME level.
• Remains current with vendor contracts and scope of work across the organization and facilitates cross-functional communication across Business Owners and other appropriate staff on vendor risk management.
• May be assigned as lead with designated vendors with the expectation of establishing strong relationship to meet set key performance indicators and ongoing compliance in the event a clear Business Owner is not identified or as delegated
• Works with vendors, business units and other appropriate staff to develop and manage corrective action plans as a result of potential or actual non-compliance.
• Develops and implements enhanced capabilities for accountability and integrity of daily operations
• Oversees all aspects of the Vendor Compliance Oversight Program and SLA Risk Management, establishing objectives, policies and procedures.
• Works with Finance to ensure vendors used by the organization are not on the Federal Exclusions Listing and takes appropriate action to immediately report and mitigate any such findings.
• Ensures operational processes and policies are compliant with organizational standards and applicable local, state and federal regulations.
• This position works closely with Legal, Compliance, Finance and Quality as well as Business Owners across the organization.
• May develop, facilitate and/or manage compliance risk management and related required trainings to ensure contractual and regulatory requirements are met
• Coordinates and/or conducts at a minimum an annual compliance risk assessment to include, but not be limited to: vendor oversight and SLA Risk Management as well as a workplan to mitigate identified and prioritized potential risks
• Develops, implements and manages issues escalation related to vendor oversight, SLA risk management and other identified compliance risk management issues.
• Performs other duties as assigned.
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Knowledge, Skills and Abilities: *
• Ability to establish and maintain effective working relationships with leadership, staff, stakeholders, state and federal officials
• Ability to effectively plan, organize, direct, coordinate and evaluate business operations including a broad range of diverse functions
• Ability to exercise sound judgment, make effective decisions and resolve problems involving complex and sensitive areas
• Ability to work collaboratively and effectively to develop processes and protocols, to analyze data and solve problems
• Knowledge and understanding of implementation and operationalizing vendor compliance oversight and risk management
• Proficient with Microsoft Office Suite (Access, Excel, PowerPoint and Word)
• Excellent interpersonal, oral and written communication skills necessary to communicate with all levels of staff and stakeholders
• Excellent program development, management and leadership skills
• Excellent phone and email etiquette skills with strong response times
• Proficient analytical and organizational, problem-solving, critical thinking and conflict management/resolution skills
• Effective attention to detail, accuracy and precision to support research and presentation skills
• Ability to prioritize, plan and organize projects and tasks
• Ability to multi-task and meet deadlines in a fast-paced environment
• Ability to maintain a professional demeanor and composure when challenged
• Ability to function autonomously and as a team member in a multidisciplinary team
• Ability to train by presenting concepts and demonstrating tasks
• Ability to perform accurate and reliable mathematical calculations to support data analysis and measure performance
• Knowledge of the principles of Medicaid Managed Care
• Excellent project management skills
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Education/Experience Required: *
Bachelor's Degree in Business, Compliance, Project Management, Health Care Administration, or related field required. Two (2) years of health plan or health system experience required. Bachelor’s Degree and five5 years of commensurate experience in lieu of specific degrees identified above is acceptable. One (1) year of experience managing delegates and/or vendor relationships required.
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Education/Experience Preferred: *
Master’s degree from an accredited college or university is preferred.
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Licensure/Certification Requirements: *
N/A
Job Type: Full-time
Hiring Insights Job activity Posted 2 days ago