- Acting compliance officer responsible for managing the compliance program including its development, performance and execution. - Acting privacy officer responsible for managing the privacy activities for the plan including overseeing privacy policies, conducting training, investigating privacy concerns and violations, and reporting privacy incidents per state and federal requirements. - Oversee compliance with the plans state managed care contract through monitoring and auditing activities that are determined through the annual audit plan. - Manage the required plan filings and related reporting with the state as part of the managed care contract but also the Department of Insurance and other company required filings. - Review new regulatory and contractual requirements and work with the business to ensure timely implementation. - Oversee the company’s delegated vendors to ensure the vendors meet the required performance requirements and any identified non-compliance or reported concerns are mitigated.

- Served as the the privacy officer role responsible for managing the privacy program of five diverse healthcare legacy companies while also integrating the privacy program in less than nine months. - Led the overall company policy and procedure integration project by executing on a collaborative process that minimizes business disruption, allows flexibility for anticipated events, and mitigates the risks relating to conflicting policies and document retention through transition.

- Develop, implement and manage the compliance program - Report compliance program status to company management and the Board of Directors- Conduct compliance training and education - Oversee compliance with regulatory, contractual and company policy requirements

• Led a team of 16 that executes an effective monitoring and auditing plan that annually identifies and recovers millions in federal health care funds due to fraud, waste and abuse. • Executed strategy to meet and exceed government contractual and regulatory requirements through implementation of advanced claims data analytics (e.g., predictive modeling), researched reported leads, conducted investigations, and assisted federal law enforcement agencies in investigations and prosecution.• Recommended million dollar cost saving solutions to the client based on executed pilot projects that detected and validated the effectiveness of a stronger control environment. • Turned around a strained client relationship within six months by listening to client needs and reallocating team priorities that continued to align with the department goals. Realignment also reduced team expenses by 30% within one year while maintaining a high client satisfaction. • Continually developed and improved team skills that resulted in 11 promotions within the department or company since 2011 including a promotion to the director level within another division. • Presented health care fraud trends and industry best practices at the National Health Care Anti-fraud Association’s (NHCAA) annual conference.

• Led team responsible for developing and managing the core corporate compliance and ethics program activities that included updating the company’s Code of Conduct and related compliance policies and procedures, developing and implementing the training and auditing plans, and managing the company’s compliance hotline and related internal investigations. • Continuously collaborated with subsidiaries, corporate departments, and legal counsel to identify company risk and provide consultation to leaders and business operations in mitigating this risk. • Presented and reported compliance program status to the chief compliance officer, executive compliance committee, and senior leadership, including the chief executive officer. • Developed the company’s core compliance training plan that aligned with senior leadership’s “tone at the top” and was executed using web-based and in-person compliance training and education that leveraged company marketing expertise to help effectively reinforce the strong ethical culture. • Coordinated specialized compliance training to newly acquired companies or departments entering new regulated environments. Training examples include the federal anti-kickback statutes, foreign anti-corruption laws, and the related company policies and procedures. • Worked with the internal audit department to conduct compliance audits based on stated objectives. Reported results to management and monitored action plans through implementation.

• Developed and implemented the company’s first Medicare Part D compliance program. The compliance program conducted training and education, monitored and audited compliance execution, identified non-compliance, and monitored action plans through implementation. • Commented on multiple proposed CMS Medicare Part D requirements, including authoring a memo and leading a discussion with the OIG HHS General Counsel and other members of the industry trade association on compliance challenges with initial Medicare Part D requirements.• Effectively presented the company’s compliance program and processes during compliance reviews conducted by the Center for Medicare and Medicaid Services (CMS) and the Health and Human Services, Office of Inspector General (HHS-OIG) with no reported deficiencies.• Continually partnered with product development, information technology, and business operations to evaluate new requirements and identify effective controls and processes that met compliance requirements and allowed the business to meet customer needs and maintain a competitive edge. • Led discussions with the company’s internal and external legal counsel to understand new regulatory requirements and determine potential company and compliance risks. • Worked closely with the privacy officer and pharmacy compliance officer to effectively meet multiple compliance training and oversight initiatives while minimizing operational impact.

• Managed staff to effectively and timely complete audit engagements per the company audit plan.• Completed various audit activities to successfully comply with Sarbanes-Oxley in its initial year.• Developed strong business relationships that were leveraged to efficiently complete audit engagements and gain business support in mitigating identified deficiencies.