Summary:

The Director Health Plan and Networks Regulatory Affairs will collaborate with the Director of Health Plans Compliance- Compliance Officer (Compliance Officer) for CHRISTUS Health Plan and Networks (CHP) and all its lines of business. The Director will be dedicated to the development, audit readiness and monitoring of the Health Plan's Compliance Program serving the needs of CHP. This role will report to the CHRISTUS Health Plan and Network's Chief Administrative Officer. The Director will collaborate with the CHP leadership team and the Corporate Compliance system team.

• Collaborates with the Director of Compliance in ensuring CHP & Networks remains compliant with state, federal and other regulatory entities in the implementation and operation of CHP & Network programs, as they relate to both state and federal government regulation and the Department of Health and Human Services (DHHS).
• Directs the regulatory team to provide training for Associates for HIPAA Privacy annual requirements and monitors that departments are compliant with Federal and, State, regulatory requirements.
• Collaborates with both the system and CHP compliance teams to provide current interpretations of the requirements in relation to the organization's operations, as well as providing new information for continuous standards of compliance.
• In coordination with the Compliance Officer develops, coordinates, monitors and/or presents communication plan(s) to educate Associates in the organization on regulatory compliance requirements.
• Ensures the organization complies with policies, procedures and practices that accurately reflect the most current regulatory requirements. Assesses current operations making recommendations, executes changes, and monitors effectiveness and adherence.
• Plans and rapidly adopts new and revised requirements. Collects, analyzes, and reports data in support of continuous compliance audit readiness activities.
• In collaboration with the Compliance Officer, is responsible for the monitoring of CHP's Compliance Plan, Work Plan, Risk Plan and Fraud and Abuse Plan.
• Directs organization audits to assist in determining compliance with regulatory requirements. Disseminates audit and surveillance results, as necessary and directs business unit leaders in the development of corrective action plans and reports results to Senior Leadership.
• Provides continuous gap analysis; develops and manages project plans designed to identify, track and close gaps.
• Responsible for researching applicable federal and state laws and legislation (including House bills and Senate bills).
• Serves as a back-up to oversight function under the Compliance Officer.
• Performs other duties as assigned.

Requirements:

Work Type:

Full Time

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About CHRISTUS Health

CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.

Connections working at CHRISTUS Health

https://careercenter.ahip.org/jobs/18328438/director-health-plans-and-networks-regulatory-affairs