Position Summary:
The Director of Compliance oversees the Compliance program, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the organization. The position ensures the Board of Directors, management and employees are in compliance with and adhere to all applicable laws, regulations, and industry standards within the insurance sector. This role involves developing, implementing, and maintaining compliance programs, serving in a leadership role on audits, and acting as a key resource on regulatory matters.
Essential Functions:
- Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance program as a result of state and federal law regulation to prevent illegal, unethical, or improper conduct. Manages day-to-day operation of the Program.
- Develops and periodically reviews and updates Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees.
- Collaborates with other departments (e.g., Human Resources, Risk Management, Internal Audit, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with the Chief Administrative Officer as needed to resolve difficult legal compliance issues.
- Acts as an independent review and evaluation body to ensure that compliance issues/concerns within the organization are being appropriately evaluated, investigated and resolved.
- Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
- Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
- Provides reports to the board and senior management as requested.
- Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
- Establishes and provides direction and management of the compliance Hotline.
- Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline; (b) heightened awareness of Standards of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.
- Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.
- Monitors the performance of the Compliance program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness.
Qualifications/Education/Experience:
- Bachelor’s degree required; Master’s degree or compliance certification preferred.
- 10 years’ experience preferred in compliance or regulatory affairs, preferably in an insurance or healthcare organization, to include demonstrated leadership.
- Strong knowledge of HIPAA, insurance regulations, and industry best practices.
- Strong attention to detail and ability to manage confidential information.
- Active attorney license in the state of Virginia preferred.
- Experience or familiarity with internal audit or enterprise risk management processes is a plus.
- Demonstrated experience leading people and getting results through others.
- Ability to think and plan strategically for organizational success.
- Strong interpersonal and communication skills.
