Director, Compliance
JOB TITLE: Director, Compliance
DEPARTMENT: Compliance
REPORTS TO: SVP, Population Health & Equity
TYPE: Full Time, Exempt
LOCATION: Remote
Role Summary
The Director, Compliance is responsible for Healthmine’s compliance program approved by Healthmine’s Board of Directors and in accordance with the 7 Elements of an Effective Compliance Program, reporting to the SVP, Population Health & Equity and leading day-to-day compliance operations. This position ensures that the company functions in a legal and ethical manner while meeting business goals. The Director, Compliance oversees the adherence of different business units to company compliance policies, and is considered the expert on company policies, processes, and regulatory systems that govern business operations both internally and externally.
What You Will Do
Regulatory & Policy Compliance
- Lead and enhance Healthmine’s compliance with regulatory frameworks, including HITRUST, NCQA, and other client-specific standards.
- Develop and regularly update policies and procedures to reflect current regulations and industry best practices.
- Lead cross-functional coordination to ensure regulatory reporting deadlines are met.
- Regularly report to ELT concerning the Company’s adherence to the 7 Elements of an Effective Compliance Program.
Risk Management & Auditing
- Conduct internal audits to identify risks, gaps, and areas of non-compliance.
- Develop, lead, and monitor organizational and third-party risk assessments.
- Drive risk mitigation plans and track remediation progress.
Project & Program Oversight
- Direct cross-departmental compliance projects, including HITRUST certifications and NCQA accreditation.
- Oversee compliance-related contract review to ensure alignment with current and future business needs.
- Create and manage the annual Compliance Workplan, ensuring all initiatives are prioritized and executed effectively.
Governance & Stakeholder Communication
- Serve as Compliance Officer and primary contact for all internal and external compliance matters.
- Identify and engage key stakeholders in the policy development and governance process.
- Maintain and oversee the policy library, including publication and version control.
Training, Reporting & Communication
- Oversee company-wide compliance training programs, including onboarding and annual refreshers.
- Prepare annual and interim compliance reports for the Board of Directors, including presentation of metrics and risk areas.
- Prepare annual training for the Board of Directors and attestation process.
- Organize and lead quarterly Compliance Team meetings, including agenda development, content ownership, and documentation.
- Manage the compliance ticketing system and escalate or investigate issues as necessary.
- Ensure ongoing communication of compliance standards across the organization.
Incident Response Management
- Regularly review all internal compliance audit and investigation reports pertaining to the organization.
- Coordinate internal investigation(s) of alleged violations of ethics and/or compliance standards.
- Manage internal Incident Response Team (IRT) and ensure timely response to reported incidents and/or investigations and execute on IRT follow-up items and documentation.
Other Responsibilities
- Take prompt action on compliance related concerns or violations.
- Stay informed on relevant regulatory changes and industry trends.
- Perform additional duties as assigned.
What You Need
- 7+ years of direct experience running compliance programs both working internally and with external support from consultants
- CHRC, CHC, or equivalent certification required
- Experience with healthcare technology solutions, preferably SaaS products, around member engagement initiatives
- Understanding of Medicare, Medicaid, CMS Marketing Guidelines, and other healthcare regulations required
- Extensive understanding of compliance and information security specifically around HITRUST certification and policies and procedures
- Strong project management skills and adherence to deadline driven business practices
- Excellent verbal and written communication skills
- Board-level presentation preparation skills
- Collaborative approach
- Critical Thinking
- Strategic Thinking
- Understanding of legal and ethical application to business
What We Provide
Competitive base salaries, full benefits (medical, dental, vision), and company paid STD/LTD benefits.
- 401(k) with match and 100% vested on first day of contribution.
- A hybrid work model and flexible work schedules.
- Generous Universal Parental Leave.
- 18 PTO days and 16 Paid Holidays.
About Healthmine
Healthmine is a technology-enabled member engagement and rewards company. We build personalized, ongoing engagement strategies for health plans that drive healthy action through incentives and rewards, enhance member experience, and improve outcomes.
Please note any outreach from a Healthmine Team Member will come from an email address ending with @healthmine.com. Any email from @healthminecareers.com email domain is in no way affiliated with Healthmine Services, Inc.
Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
Healthmine provides equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, pregnancy, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Healthmine will provide reasonable accommodations for qualified individuals with disabilities.
