Associate, Risk/Compliance

About the Role

Our client, a pioneering health insurance company built on a full-stack technology platform, is seeking an Associate, Risk/Compliance to join its Corporate Compliance team. This company focuses relentlessly on serving its members with the vision of creating a health insurance experience akin to having a doctor in the family.

Key Responsibilities of the Associate, Risk/Compliance

The Associate, Risk/Compliance plays a crucial role in ensuring the organization adheres to all industry specifications, standards, regulations, and laws. This involves a comprehensive approach including reviewing operational practices, developing and implementing robust policies and procedures, and conducting thorough regulatory reviews. The core objective is to ensure and enforce complete compliance across all facets of the business.

• Communicate with relevant departments to ensure current compliance levels.
• Provide essential training to team members on regulatory compliance.
• Ensure all team members are aware of necessary compliance procedures.
• Develop and implement effective compliance improvement plans.
• Delegate tasks to other departments to enhance compliance levels.
• Develop comprehensive reports for the governing body.
• Assist Regulatory Authorities during site visits and external audits.
• Prepare for and conduct audits in collaboration with external authorities.
• Conduct regular internal audits in all required areas to maintain compliance.
• Ensure compliance with all applicable laws and regulations.
• Perform other duties as assigned.

Work Location

This is a fully remote position for candidates residing in Dallas, TX. While currently remote, the work model may evolve, potentially including a hybrid presence at a hub office in the candidate's metro area in the future.

Compensation and Benefits

The base pay for this role ranges from $88,560 - $116,235 per year. This position also includes eligibility for employee benefits, participation in the organization's unlimited vacation program, and annual performance bonuses.

Full-time employees enjoy medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Requirements

• Bachelor's Degree or equivalent work experience.
• 1+ year experience in health plan compliance.
• 2+ years experience with State DOI health insurance rules and regulations, CMS ACA rules and requirements, and CMS requirements.
• 2+ years experience managing high-volume, complicated projects, demonstrating strong attention to detail and timely project completion.

Preferred Qualifications

• CHC, CCEC, or similar certification.
• Fluency with State DOI audit and/or reporting obligations.
• State DOI audit management experience.
• Experience in a start-up and/or health tech environment.
• Experience in a TPA setting.

Key skills/competency

• Regulatory Compliance
• Health Plan Regulations
• CMS ACA Rules
• State DOI Audits
• Policy Development
• Compliance Training
• Project Management
• Risk Management
• Internal Controls
• Healthcare Compliance