Senior Director of Licensing

2 days ago

Dallas, Texas, United States National HealthCare Solutions, Inc. Full time

POSITION SUMMARY

The Senior Director of Licensing & Compliance will lead licensing operations and regulatory compliance initiatives across multiple domestic entities, specifically in Pharmacy Benefit Management (PBM), Third-Party Administrator (TPA), and Stop-Loss operations. This role is responsible for ensuring compliance with federal and state regulations, streamlining licensing processes, and strengthening compliance frameworks. This position serves as the principal corporate resource for regulatory interpretation and application to support strategic business initiatives.

DUTIES AND RESPONSIBILITIES

The essential functions include, but are not limited to the following:

Regulatory Compliance Oversight

  • Monitor and interpret federal and state regulations including DOL, CMS, ERISA, ACA, HIPAA, and DOI requirements.
  • Develop, implement, and refine compliance policies and procedures.
  • Maintain regulatory calendars and compliance dashboards.
  • Advise senior leadership on regulatory changes and their business impacts.

Licensing Management

  • Oversee licensing applications, renewals, and regulatory reporting for PBM, TPA, and Stop-Loss.
  • Evaluate and optimize licensing processes through technology solutions.
  • Assist employees with individual licensing renewals.
  • Serve as liaison with regulatory agencies, managing inquiries and audits.

Compliance Program Development

  • Design comprehensive compliance programs aligned with corporate goals.
  • Conduct risk assessments and internal audits.
  • Develop and lead compliance training programs.
  • Oversee external audits and third-party assessments.
  • Establish protocols for internal investigations and remediation.

Cross-Functional Collaboration

  • Advise on regulatory matters during mergers, acquisitions, or expansions.
  • Act as compliance expert during contract negotiations.
  • Collaborate with Legal, Clinical Strategy, Pharmacy Network, and Customer Service teams.
  • Respond to regulatory complaints and inquiries.

Reporting and Documentation

  • Prepare compliance reports for senior leadership and regulatory agencies.
  • Maintain detailed compliance records, including audits and investigations.
  • Oversee responses to regulatory engagements and exams.
  • Complete government census surveys and regulatory filings.

Other job duties include, but are not limited to the following:

  • Supervising compliance and licensing team members.
  • Ensuring timely and accurate reporting to regulatory bodies.

MINIMUM QUALIFICATIONS (KNOWLEDGE, SKILLS, AND ABILITIES)

Education

  • Bachelor's degree in Business Administration, Healthcare Administration, Law, or related field (required).
  • Master's degree (MBA, MHA, JD) strongly preferred.

Experience

  • 10+ years in healthcare regulatory compliance, with expertise in PBM, TPA, or Stop-Loss operations.
  • Proven experience developing and managing compliance programs.
  • Expertise in federal and state healthcare regulations.
  • Team and vendor management experience.

Skills & Competencies

  • Proficiency with compliance management systems and automation platforms.
  • Strong analytical, leadership, and problem-solving skills.
  • Excellent communication and collaboration abilities.
  • Detail-oriented and committed to accuracy and integrity.
  • Ability to manage and develop compliance teams.

Certifications

  • Certification in Healthcare Compliance (CHC) or equivalent (preferred).
  • Commitment to continuing education in compliance and healthcare law.

OTHER DETAILS

Supervisory Responsibilities

Manages compliance and licensing teams, providing coaching, performance management, and professional development.

  • Senior Membership Director-Moody Family YMCA

    2 days ago

    Dallas, Texas, United States YMCA of Metropolitan Dallas Full time

    The YMCA of Metropolitan Dallas, established in 1885, consists of 16 branches and one destination camp and employs over 2000 staff - all dedicated to building healthy, confident, connected, and secure children, adults, families and communities. We are currently seeking a Senior Membership Director to serve at our Moody Family YMCA.Under the direction of the...

  • Senior Program Director

    7 days ago

    Dallas, Texas, United States CESO, INC. Full time $120,000 - $200,000 per year

    Are you seeking purpose, challenge, and talented colleagues? With a diverse portfolio of residential, energy, commercial, light industrial and public programs, CESO has the opportunity for you to develop your career. We develop leaders and empower our associates to use their skills and talents to positively impact the world through service – to our...

  • Director of Trademarks and Licensing

    7 days ago

    Dallas, Texas, United States Southern Methodist University Full time $80,000 - $120,000 per year

    Director of Trademarks and Licensing - (ATH DescriptionSalary Range:Salary commensurate with experience and qualificationsAbout SMUSMU's more than 12,000 diverse, high-achieving students come from all 50 states and over 80 countries to take advantage of the University's small classes, meaningful research opportunities, leadership development, community...

  • Senior Director Technology Development

    1 week ago

    Dallas, Texas, United States UT Southwestern Medical Center Full time $200,000 - $250,000 per year

    WHY UT SOUTHWESTERN?With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth...

  • Senior Director, FP&A- Health

    7 days ago

    Dallas, Texas, United States Integrity Marketing Group Full time $120,000 - $250,000 per year

    SummaryWe are seeking a highly skilled FP&A Senior Director to join our growing FP&A department at Integrity. The FP&A Senior Director will be part of the Shared Services FP&A team and will lead all aspects of financial planning and analysis, forecasting, budgeting, and consolidated management reporting for Integrity. This position reports to the CFO of...

  • Senior Business Development Director

    3 days ago

    Dallas, Texas, United States Confisa International Group Full time $150,000 - $250,000 per year

    Sr.Business Development Director / Sales Hunter - Semiconductor IndustryPosition: Senior Business Development Director / Business Development Director Location: Austin / Dallas – Texas (Hybrid) Company Overview:Our client is a technology and engineering company that provides engineering research and development services.Experience Background in ASIC...

  • Senior Director-Paid Media

    6 days ago

    Dallas, Texas, United States Spinutech Full time $120,000 - $180,000 per year

    Spinutech is looking for an experienced Senior Director of Paid Media to add to our growing agency team You will oversee the day-to-day operations of the digital media department, providing strategic leadership, team development, and hands-on expertise across Paid Search, Paid Social, Programmatic, Display, and AI-powered advertising solutions. You will be...

  • Senior Director, Master Data Manager

    6 days ago

    Dallas, Texas, United States Integrity Marketing Group Full time $120,000 - $250,000 per year

    Senior Director, Data ManagementWe are seeking a highly skilled and experienced Senior Director of Data Management to spearhead our efforts towards advancing the quality, consistency and governance of data across multiple systems. You will lead cross-functional teams, architect MDM solutions, and drive the implementation of strategies to support business...

  • LVN NURSE Weekends

    1 week ago

    Dallas, Texas, United States Tradition Senior Living Full time $60,000 - $90,000 per year

    LVN NURSE - Part Time and Full-Time positions open for WeekendThe Tradition Senior Living is a Texas-based Luxury Senior Living organization committed to excellence in all we do to serve our residents. Since our inception, we have expanded to multiple locations in the Dallas, Houston, and Fort Worth areas. Each community offers a comprehensive continuum of...

  • LVN Charge Nurse Full-time

    3 days ago

    Dallas, Texas, United States Tradition Senior Living Full time $60,000 - $90,000 per year

    LVN Charge NurseFull time - Friday 9a-9p, Saturday 6a-6p, Sunday 6a-6pThe Tradition Senior Living is a Texas-based Luxury Senior Living organization committed to excellence in all we do to serve our residents. Since our inception, we have expanded to multiple locations in the Dallas, Houston, and Fort Worth areas. Each community offers a comprehensive...