Health Alliance Plan (HAP) located in Detroit, Michigan is recruiting a Chief Compliance Officer to join our leadership team.
Under the leadership of the Vice President of Business Integrity Services and the Chief Executive Officer, the Chief Compliance Officer (CCO) is responsible to implement, document, and maintain a coordinated legislative and regulatory compliance program that meets the expectations of State and Federal regulators and corporate Government for Health Alliance Plan and its subsidiaries, including Alliance Health and Life Insurance Company; HAP Preferred, Inc.; Administration Systems Research Corporation; and Midwest Health Plan (jointly referred to as “HAP”).
Principal Duties and Responsibilities:
Nurture and promote a culture of compliance throughout HAP in partnership with senior staff, managers and all other staff.
Implement, document, and maintain a coordinated regulatory compliance program.
Develop and/or implement compliance educational programs for all key stakeholders.
Identify and assess areas of compliance risks and deploy strategies to ensure ongoing effectiveness of the compliance program.
Draft policies, procedures and practices designed to promote compliance with the requirements set forth by Federal and State health care programs.
Coordinate and oversee regulatory submissions and reporting activities.
Cultivate positive relationships with key regulatory bodies and serve as a key point of contact during regulatory audits.
Serve as subject matter expert on compliance matters for HAP staff.
Implement strategies to monitor regulatory readiness.
Report to the Audit and Compliance Committee of the Board of Directors regarding compliance matters as necessary.
Manage HAP’s operational compliance committees.
Develop agendas, reports and information as requested by the CEO, the Audit and Compliance Committee of the Board of Directors, and/or the Board.
Coordinate oversight of privacy and security matters with the Information Privacy and Security Office.
Oversee and follow up and as applicable implement corrective actions to investigations and other issues generated by the compliance program.
Perform other related duties as assigned.
Leadership- Listens and communicates effectively. (Be Here Now) Coaches and mentors others. Motivates and inspires others. Has the courage to innovate. Is accessible to others. Rewards and recognizes the accomplishments of others. Demonstrates self-awareness and self-management.
Accountability for Results and Execution- Is accountable for achieving desired results. Demonstrates confidence in decisions and executes without undue delay. Leads by example (Shadow of a Leader). Demonstrates integrity and ethical behavior. Encourages and embraces diverse cultures, ideas and opinions.
Strategic Planning- Aligns individual/department/business unit goals and tactics with System goals. Translates strategies into goals and action plans. Keeps team informed about the strategic direction of the organization and everyone's role in achieving that vision. Eliminates silos or boundaries that impede local and System-wide strategy development, action plan implementation, and goal achievement (Systems Thinking).
Member/Customer Focus- Models strong personal service excellence skills creating a "Lasting Impression" for our members and customers. Develops service skills in others, and holds others accountable to uphold the HFHS "Team Member Standards of Behavior." Creates an environment that "puts patients first by providing the quality of care and comfort we want for our families and ourselves." Seeks out and uses data from members and other customers in developing world-class processes and in continuous improvement efforts in service excellence.
Performance Analysis and Knowledge Management- Demonstrates competence and credibility in area(s) of responsibility (i.e., technical, professional, and, if appropriate, clinical proficiency). Understands and interprets performance reports from all pillars to drive decision-making; uses data to evaluate the potential risk and returns on investment. Actively seeks and incorporates feedback and best practices from others in order to learn and improve. Shares knowledge with others to drive organizational improvement.
Staff Focus- Creates a stimulating, rewarding and engaging work environment for team members. Puts the right people in the right role (or assigns the right tasks) at the right time. Encourages and challenges staff to take risks and be innovative. Supports and encourages the development of others; facilitates their personal growth and offers assistance. Celebrates achievements, contributions, and accomplishments. Demonstrates honesty and consistency in communications with staff. Create a collaborative culture by demonstrating a positive attitude and hopeful energy.
Process Management and Focus on Safety- Sets expectations and targets that are aligned with system goals in the areas of member safety and quality. Seeks and practices continuous improvement of products, services and processes. Is an agent of change (e.g., challenges the status quo; suggests alternative solutions to challenging problems, supports others with change). Creates an environment where people feel "safe" to speak up and speak out about safety issues and/or inappropriate behaviors. Follows guidelines of local and System-wide quality and safety initiatives, such as the No Harm campaign. Models and strictly enforces personal safe practices (e.g., hand-washing).
Bachelor's degree in health care administration, public health or business
7+ years related experience and/or training
Previous Medicare, Medicaid, FEHB, HIPAA and federal health reform regulatory experience in a managed care environment
Successful development and implementation of government programs compliance plan
Certification in compliance field by organizations such as the Health Care Compliance Association (HCCA) or National Health Care Anti-fraud Association (NHCAA).
Compliance experience with a carrier intending to offer or offering ACA exchange/insurance market place health plans.
Health Alliance Plan (HAP) is a nonprofit, regional health plan headquartered in Detroit.
Our mission: “to enhance the health and well-being of the lives we touch.”
HAP excels in delivering award-winning disease management, wellness and community outreach programs, and highly personalized customer service.
Henry Ford Health System Alignment:
• HAP is a subsidiary of Henry Ford Health Sys...tem, one of the national’s leading health care systems and a proud recipient of the 2011 Malcolm Baldrige National Quality Award for performance excellence and innovation.
• HAP serves an important role in promoting system integration and care coordination and acts as a catalyst in forming innovative patient care, community, business and economic partnerships. As the voice of the customer, HAP partners with HFHS to improve quality while maintaining a focus on value, affordability and accessibility.
• HAP has more than 1,300 employees in Detroit, Southfield, Flint and Grand Rapids.
• We serve more than 650,000 members through six product lines:
o Group Insured Commercial: PPO, EPO and HMO; Health Engagement programs offer employees incentives to adopt a healthier lifestyle.
o Individual: HAP Personal Alliance PPO, HSA and Short-Term health plans are for individuals and families not covered through employer health insurance.
o Medicare Solutions: HAP Medicare Solutions offer PPO and HMO plans, prescription drug plans, and Medicare Supplement plans for individuals and employer-sponsored retirees.
o Medicaid: HAP Midwest Health Plan has about 10,000 Medicare and Medicaid enrollees.
o Self-Funded: HAP and ASR Health Benefits offer competitive options for Michigan companies and health and welfare funds seeking to self-fund their health benefit costs.
o Network Leasing: Statewide PPO network that can be administered by Third Party Administrators and Welfare Funds