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Role Description

Who We Are:

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are

A Chief Compliance Officer who is responsible for the development, implementation, strategy, management, and oversight of the organization’s Compliance Program. You will be responsible for leading the operational efforts of the Compliance Program which include implementing and maintaining programs and infrastructure designed to ensure that company meets statutory and regulatory requirements relating to fraud, waste and abuse laws and data privacy. You are responsible for reporting on the company’s compliance performance, culture of ethics, and risks to the executive leadership team and supports the alignment of organizational policies and practices to the applicable compliance strategies.

The Opportunity

• Provides effective leadership and advice to the executive leadership team on matters of corporate compliance and ethical business practices.
• Oversees, coordinates, and monitors the day-to-day compliance activities of the organization.
• Oversees the SOC and HITRUST audit preparation and submission.
• Monitors the regulatory environment, assesses the impact of proposed/changing laws and regulations, and recommends enhanced business strategies, practices and policies to senior management.
• Oversee the development and execution of policies and procedures as well as effective communication and training strategies which promote awareness and understanding of ethics and compliance principles consistent with the mission, vision, and core values of Advantasure and required regulations.
• Advise internal stakeholders of potential compliance risk areas.
• Supervises, manages, and leads the members of the Compliance Team.
• Collaborate with and support leadership (e.g., Legal, Sales, Marketing, Operations and Human Resources) on compliance matters to ensure adherence with laws, regulations, standards, guidelines, best practices, and the Code of Conduct.
• Performs other related duties which may not be specifically listed in the position description, but which are within the general occupational series and responsibility level typically associated with the employee’s class of work.

What You Need

• Bachelor’s degree is required. Master’s degree is preferred. Certification/license or progress toward certification/license is highly preferred and encouraged.
• At least ten years of progressively more responsible compliance experience in a healthcare environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities. Healthcare experience required. Experience with SOC and HITRUST audits strongly preferred.
• Strong knowledge of state and federal CMS (Centers for Medicare & Medicaid Services) regulatory compliance matters.
• High degree of professional ethics and integrity required
• Sound judgment and ability to analyze situations and information required
• Extensive knowledge of managed health care industry, health plans and large group physician organizations.
• Strong strategic planning, program development, project management, and staff development skills.
• Excellent analytical, organizational and problem-solving skills, and senior level skills in managing ambiguous situations and issues.
• Ability to develop and implement effective and efficient recommendations.
• Seasoned management skills to motivate and inspire optimum performance.

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $235,000-300,000

A successful employee in this role may be eligible for incentive payments based on company and individual performance.

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

• Simplicity

Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

• Integrity

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

• People-Centricity

Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

• Leadership

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

#Healthproof

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Skills

Healthcare,Compliance,Compliance Management,Audit Compliance