Job Details
The Health Connector is seeking a Compliance Specialist to support the Health Connector s Senior Compliance Manager in the coordination of its compliance activities, including monitoring its various audits. This individual will report to the Senior Compliance Manager, as part of the office of the General Counsel, and will have significant independent responsibility to oversee compliance programs and to respond to suspected incidents of non-compliance. This individual will help to develop effective policies and procedures to ensure compliance, raise employee awareness of compliance issues, and address and remediate any problems or incidents. Specific areas of compliance will include federal regulations of health insurance exchanges, state insurance laws, federal and state privacy and security requirements, and other legal requirements.
Key Responsibilities include:
Ensuring Health Connector compliance with requirements for a public health insurance exchange, including analysis of regulatory and statutory requirements and identification of any compliance gaps.
Developing, initiating, maintaining, and revising policies and procedures and standards of conduct to ensure compliance and to prevent illegal, unethical, or improper conduct.
Collaborating with other Health Connector departments (e.g., operations, policy, information technology, or finance) to direct compliance issues to appropriate channels for investigation and resolution. Consulting with in-house legal staff as needed to resolve difficult legal compliance issues.
Monitoring compliance hotlines. Investigating and acting upon any complaints or reports of suspected non-compliance, improper conduct, or waste, fraud or abuse, and/or privacy or security breaches. Overseeing a system for the uniform handling of such complaints or reports.
Responding to public records requests, including by evaluating the legitimacy of such requests and collaborating with other Health Connector staff to compile and produce responsive records
Identifying potential areas of compliance vulnerability and risk and assisting in developing appropriate responses to correct or remediate problematic issues.
In collaboration with legal staff, developing and delivering regular trainings and other activities to heighten employee awareness of employee standards of conduct, reporting obligations, and understanding of the Health Connector s legal obligations and potential areas of risk.
Ensuring proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
Reporting regularly to the senior compliance manager on the progress and operation of compliance activities and various audits.
Procuring, managing and directing external audits of Health Connector operations, working in coordination with the Health Connector financial, legal and operations teams.
Providing reports and updates to federal regulatory agencies on compliance activities. Responding to inquiries or information requests, as they occur.
Researching and performing analysis to support program integrity processes, as necessary.
Experience and Qualifications:
Bachelor s degree is preferred.
A minimum of two years experience in compliance or legal support is required. Experience with health care, insurance, regulatory interpretation, and/or government operations strongly preferred. Experience or familiarity with IT system operations or data management preferred.
Demonstrated ability to assume leadership and work independently.
Strong ability to communicate effectively both orally and in writing.
Strong organizational skills and detail-oriented focus.
If interested:
Send cover letter and resume to ...@state.ma.us.
Salary:
$85,000-90,000/year
Please note:
Due to the requirement of 268A, please complete the disclosure form and return with your application. Link -
All Health Connector employees are required to provide satisfactory proof of eligibility to work in the United States
All Health Connector employees are required to provide satisfactory proof of full COVID vaccination.
The Health Connector is operating on a hybrid work arrangement with 2 days in the downtown Boston office and 3 days working from home.
About the Connector:
The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities. More information about the Connector and its programs is available at www.MaHealthConnector.org.
The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its work force. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, gender identity, national origin, or disability.