Director, Compliance & Regulatory Affairs

Job Number: 1261

Workplace Type:

Position Title: Director, Compliance & Regulatory Affairs

External Description:

Alignment HealthCare USA and its affiliates and subsidiaries, including Alignment Health Plan, (AHC) are committed to maintaining an effective compliance program for promoting compliance with laws, regulations and company conduct requirements that govern operation of the organization.  The Director of Compliance and Regulatory Affairs (“Compliance Director”) is part of the management team responsible for the day to day operation of the AHC Compliance Program and reports directly to the Vice President of Compliance and Regulatory Affairs.

This Compliance Director is a leader and regulatory subject matter expert, joining enterprise-wide projects to achieve business operational excellence and compliance with all measures relative to State and Federal Compliance and HIPAA initiatives.  The Compliance Director will immediately educate his/herself on any new applicable State and Federal regulations, and provide guidance and interpretation of new regulations throughout the organization to ensure the executives, management, employees and contractors are educated on 

General Duties/Responsibilities: (May include but are not limited to)

As part of the Compliance and Regulatory Affairs management team, in ensuring complete and compliant development, implementation and management of the day-to-day operations of the Compliance Program, the Compliance Director will:

• Direct, coordinate, and monitor efforts to ensure operational compliance with (a) applicable federal and state laws and regulations, (b) CMS contract and Part C and Part D Program requirements, (c) Compliance Department and operational policies and procedures as they relate to compliance, and (d) the Alignment standards of conduct requirements;
• Provide reports to the Vice President of Compliance and Regulatory Affairs and the Operational Compliance Committee on a regular basis, and as directed or requested, to keep the AHC Board members and Executive Management informed of the operation of progress of compliance efforts;
• Respond to alleged violations of rules, regulations, policies, procedures and Standards of Conduct by initiating investigative procedures, including developing and overseeing a system for uniform handling of such violations;
• Assist in defining the compliance program structure, educational requirements, reporting, and complaint mechanisms, response and correction procedures, and compliance expectations of all personnel and FDRs;
• Work with the Alignment Legal team to conduct state-specific regulatory research, interpret and monitor changes to requirements to mitigate risks and achieve compliance;
• Develop, evaluate, implement and maintain applicable Compliance policies and procedures, and oversee and monitor the business’ creation of appropriate policies & procedures to help ensure Alignment is compliant with applicable laws, rules and regulations;
• Institute effective compliance activities through an efficient use of resources and a focus on continuous performance improvement initiatives designed to maximize compliance; and
• Embody and promote an overall culture of compliance that encourages ethical conduct and a commitment to compliance with the law.

Supervisory Responsibilities:

None at this time

 

Minimum Requirements:

Minimum Education/Experience:

• The Compliance Director should have credentials and experience appropriate for (1) understanding the Medicare MA/Part D Program, and (2) executing the duties and responsibilities set forth in the AHC Compliance Program;
• HIPAA Privacy expertise or certification a plus;
• Bachelor’s degree, 5 years’ experience in a healthcare organization, demonstrated leadership abilities, or any combined equivalent.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Director, Compliance & Regulatory Affairs

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].