Vice President | Compliance & Privacy

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Vice President | Compliance & Privacy

• Reports to
  :
  Co-Chief Legal Officer

• Location
  :
  On-site in either Green Bay or La Crosse, WI

Reporting to the Co-Chief Legal Officer, this role leads and assumes management responsibility for the structure, development, implementation and operation of Emplify Health's enterprise Compliance and Privacy Programs to ensure compliance with state and federal laws, regulations, and policies to help prevent fraud and abuse. The VP, Compliance & Privacy serves as a trusted advisor to management and board, offering guidance and practical solutions to complex regulatory compliance challenges.

Provides periodic reporting to the enterprise Board. The VP, Compliance & Privacy will also coordinate with other key stakeholders involved in enterprise risk management. The VP formulates and enforces policy, consistent with Emplify Health standards.

• Creation and implementation of comprehensive compliance and privacy strategies, risk assessments and detailed audit plans for the Enterprise.

• Oversee development and implementation of compliance and privacy policies, procedures, processes, training, and best practices to promote compliance with applicable laws and regulations.

• Oversee compliance investigations to ensure they are conducted timely and effectively and that corrective action if applicable is initiated and sustained.

• Provide influential, collaborative leadership and guidance to Emplify executive leadership and operations on compliance, privacy, ethics and regulatory issues to reduce risk and enable strategic business objectives.

• Develop and maintain strong stakeholder relationships across the business to support compliance and privacy initiatives.

• Partner with Emplify leadership to further enhance culture of compliance throughout the Enterprise.

• Collaborate with various departments, subject matter experts, and external partners to ensure compliant solutions for business needs.

• Manage a team of compliance and privacy professionals dedicated to ethical and compliant business practices.

• Oversee development and delivery of effective compliance and privacy programs designed to detect, prevent, and address issues across the Enterprise.

• Ensures the Enterprise operates a Compliance Program that includes the 7 elements of a Compliance Program as outlined by the Office of Inspector General.

• Ensures detailed records are maintained to document compliance and privacy research, issues, audits, investigations, efforts, corrective actions and informed decision-making.

• Continuously monitor legal and regulatory environments affecting the Enterprise.

• Oversees monthly background screening against OFAC, SAM, EPLS, OIG and applicable state Medicaid databases

• Oversee and support communications, issue resolution, and overall compliance engagement with regulators in partnership with operations, legal and business teams as such matters relate to Compliance Program and Privacy Program activities.

• Oversee collaboration with operations, and other functional areas to review, analyze and develop/oversee initial implementation project plans and/or corrective action plans to ensure compliance with new or existing laws and regulations.

• Oversees the Conflict of Interest Management program for the Enterprise.

• Reviews grant applications for compliance with grant requirements.

• Responsible for Compliance and Privacy budget development.

• Organizational Strategy and Implementation: Recognizes market trends, judges the impact on their area of responsibility, contributes to responsive strategic plans, develops operational plans, and ensures alignment and commitment of all staff.

• Fiscal Management: Effectively uses established processes to ensure accountability for effective operations and resource management.

• Human Resource Management: Selects, aligns, develops, motivates, manages, and retains a team of highly skilled employees.

• Excellence in Service and Quality: Achieves seamless delivery of quality patient care, safety,…