Director of Compliance
About The Position
The Director of Compliance leads all of Gravie’s compliance initiatives, including the design, development and implementation of all appropriate controls and processes required to comply with federal and state regulations. This person works closely with Gravie business leaders to understand compliance requirements as we design new products and services and improve those we already have. This role will be accountable for implementing all the necessary actions to ensure the successful achievement of the objectives of an effective compliance program.
· Serve as a subject matter expert, with independent review and evaluation of current ERISA, HIPAA, and NIST requirements and how all those requirements intersect with our business. Identify potential areas of compliance vulnerability and risk; develop/implement corrective action plans for resolution of problematic issues and provide general guidance on how to avoid or deal with similar situations in the future. This includes serving as the HIPAA Compliance Officer for Gravie.
· Collaborate with business leaders and functional areas as Gravie works to develop innovative and member-centric benefit solutions. Advise of compliance requirements and considerations for new ideas and help shape an end product that’s compliant and thrills our members. Consult with external counsel as needed to resolve difficult legal compliance issues.
· Develop, initiate, maintain, and revise policies, procedures and plans for the general operation of the compliance program and its related activities. Implement controls required by HIPAA, NIST and other applicable regulations. Manage day-to-day operation of the compliance program.
· Maintain an effective compliance communication program for the organization. Oversee the implementation of compliance procedures and training programs that help all employees understand and comply with all required compliance rules and regulations. Provide regulatory updates when applicable.
· Lead incident response team in triaging and responding to any HIPAA incidents or breaches. Respond to alleged violations of rules, regulations, policies and procedures, by evaluating or recommending the initiation of investigative procedures. Oversees uniform handling of such violations.
· Oversee insurance producer licensing and ensure compliance with all applicable state licensing laws and regulations, and execution and maintenance of agency/agent appointment contracts with health insurance carriers nationwide, including tracking any contractual requirements.
· Oversee Gravie’s contract administration process and serve as a collaborator on contract drafting and negotiations.
· Provide reports and counsel on a regular basis, and as directed or requested by leadership.
· Provide mentoring, management and guidance to compliance team member(s).
· Demonstrate the Gravie competencies of authenticity, creativity, curiosity and outcome orientation.
· BA degree or higher from college or university
· An extensive compliance, regulatory and/or legal background related to health insurance and healthcare
· Experience developing or managing contracts
· Previous experience advising team members on new product development
· Very strong attention to detail and ability to manage complex and ever-changing data
· Exceptional verbal and written communication skills