[Remote] Director Ethics and Compliance

Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is seeking a Director of Ethics and Compliance to serve as the Account Compliance Officer. This role involves developing and managing compliance programs for healthcare and pharmacy benefit manager clients, overseeing compliance activities, and leading investigations related to fraud, waste, and abuse.

Responsibilities

• Develop and administer account compliance program and risk assessments
• Develop and update account-specific compliance addenda to corporate policies, procedures, guidance, and training for employees
• Monitor and provide updates regarding federal and state regulations related to account compliance program, including healthcare, pharmaceutical, and/or pharmacy benefit manager requirements
• Monitor and assess staff member compliance with policies, procedures, and laws and regulations
• Develop, oversee, and provide reports regarding account compliance program, including compliance activities, risk assessments, audits, and compliance with regulatory and contractual requirements
• Develop preventative and corrective strategies and action plans, as needed, to support the account compliance program, risk assessments, and contractual and regulatory requirements
• Maintain documentation supporting the Corporate and/or account compliance program, including compliance policies and procedures, manuals, risk management plan, fraud, waste, and abuse plan, etc
• Communicate with leadership and client regarding account compliance program, activities, risk assessments, audits, etc
• Lead internal and external compliance-related discussions, presentations, and activities
• Assist with audits by clients and government agencies
• Conduct or assist with investigations, as needed

Skills

• 7+ years of experience in corporate healthcare, pharmaceutical, and/or pharmacy benefit manager compliance and ethics experience is required
• Graduate or post-graduate degrees in law and/or experience in the pharmaceutical and compliance industries is required
• Certification in healthcare compliance or privacy (e.g., CHC, CHPC, CHRC, or CHC-F)
• Experience leading a team, including professional development and performance management for team members is required
• Experience formally and informally leading and collaborating with all levels of management in compliance-related activities is required
• State or federal agency experience highly desired
• Experience in pharmaceutical and/or compliance training course design, development, and implementation strongly preferred
• Experience with healthcare compliance program planning and implementation
• Experience with risk management analysis and strategies, and ability to link risk management practices to business needs and activities
• Knowledge of and experience with regulatory compliance requirements related to Medicare and Medicaid reimbursement, fraud, waste, and abuse laws, and HIPAA
• Skilled in planning, problem solving, analysis, and collaboration
• Excellent understanding of project management principles
• Excellent presentation, written and verbal communication skills
• Strong organizational skills, and ability to handle multiple high-pressure situations simultaneously
• Proficient with Office 365 (Word, Excel, PowerPoint, Teams, and SharePoint)
• Experience working with large data and detecting noncompliance and fraud, waste, and abuse

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• A variety of leadership and technical development academies to help build your skills and capabilities

Company Overview

• Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital. It was founded in 2009, and is headquartered in Irving, Texas, USA, with a workforce of 10001+ employees. Its website is https://www.gainwelltechnologies.com/.

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