Senior Manager, Regulatory Compliance
Albuquerque, New Mexico, United States
Implemented National Compliance Policies and Procedures• Responsible for implementation of processes and controls to support compliance operations in New Mexico, reporting directly to the President of the NM market and VP of Compliance for DMG.• Prepared and delivered education to employees on compliance initiatives and policies.• Reviewed/maintained conflict of interest (COI) records and educated on the COI policy.• Collaborated daily with Regulatory and Operations Attorneys, Privacy, Risk, and every department amongst Operations to remediate issues that arose within the business.Compliance Operational Responsibility• Managed compliance projects, investigations, and processes included tracking and reporting updates to senior leadership.• Lead the NM Quarterly Compliance Committee, providing updates on key risk areas, initiatives, and compliance program effectiveness.• Managed the hotline to ensure each report was reviewed and promptly sent to the appropriate department/market for resolution.• Assisted in ensuring all Federal and State regulatory changes were communicated to the market and tracked changes needed for compliance.• Helped with ongoing compensation reviews as well as larger strategic discussions, policy changes on provider comp, and new initiatives. Liaison between the regional Chief Medical Officer and the national provider compensation governance process.• Responsible for employee compliance training.