Compliance and Privacy Officer

2 weeks ago


Smithfield, Rhode Island, United States ASSOCIATION FOR COMMUNITY AFFILIATED PLANS Full time
Job Title: Compliance and Privacy Officer

Neighborhood Health Plan of Rhode Island is seeking a highly skilled Compliance and Privacy Officer to join our team. As a key member of our Compliance Department, you will be responsible for ensuring our organization's compliance with federal, state, and local laws, rules, and regulations.

Key Responsibilities:
  • Develop, implement, and maintain our Compliance Program and Standards of Business Conduct.
  • Lead our Compliance Committee and provide necessary reports to the Board of Directors, CEO, COO, CMO, CFO, and Compliance Committee.
  • Ensure timely and accurate regulatory reporting, vendor compliance, and non-compliance with specific elements of our Compliance Program.
  • Oversee and assist managers in creating corrective action plans to address identified compliance issues or concerns.
  • Manage and direct our provider audit function and conduct Compliance Program-related audits and investigations.
  • Monitor government announcements, regulations, and guidance, and ensure our departments and staff members are informed and implement required changes.
  • Oversee the identification, implementation, and maintenance of our Privacy Program in compliance with HIPAA and other state and federal laws.
Requirements:
  • 5-8 years of experience in regulatory compliance.
  • Direct experience with compliance related to Medicaid, Medicare Advantage, and Prescription Drug Programs.
  • Detailed knowledge of CMS regulations for Medicaid, Medicare Advantage, and Prescription Drug Programs.
  • Demonstrated ability to work across numerous operational areas.
  • Demonstrated strong presentation, organizational, and time-management skills.
Preferred Qualifications:
  • Regulatory compliance experience with healthcare law.
  • Experience in health plan operations and managed care.
  • Health Care Compliance Association (HCCA) / Society for Corporate Compliance and Ethics (SCCE) certification.
What We Offer:

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.

This position requires a high level of attention to detail, strong analytical skills, and the ability to work effectively in a fast-paced environment. If you are a motivated and results-driven individual with a passion for compliance and privacy, we encourage you to apply.



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