5 DAYS - 8 HOURS
Director Health Plans and Networks Regulatory Affairs
CHRISTUS System Office
Minimum Overnight Travel Up To 10 Percent
CHRISTUS Corp Irving Offices 919 and 909 Buildings
919 Hidden Ridge
Irving, TX 75038
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Director Health Plans and Networks Regulatory Affairs Job in Irving
The Director Health Plan and Networks Regulatory Affairs will collaborate with the Director of Health Plans Compliance- Compliance Officer (Compliance Officer) for CHRISTUS Health Plan and Networks (CHP) and all its lines of business. The Director will be dedicated to the development, audit readiness and monitoring of the Health Plan’s Compliance Program serving the needs of CHP. This role will report to the CHRISTUS Health Plan and Network’s Chief Administrative Officer. The Director will collaborate with the CHP leadership team and the Corporate Compliance system team.
- Collaborates with the Director of Compliance in ensuring CHP & Networks remains compliant with state, federal and other regulatory entities in the implementation and operation of CHP & Network programs, as they relate to both state and federal government regulation and the Department of Health and Human Services (DHHS).
- Directs the regulatory team to provide training for Associates for HIPAA Privacy annual requirements and monitors that departments are compliant with Federal and, State, regulatory requirements.
- Collaborates with both the system and CHP compliance teams to provide current interpretations of the requirements in relation to the organization’s operations, as well as providing new information for continuous standards of compliance.
- In coordination with the Compliance Officer develops, coordinates, monitors and/or presents communication plan(s) to educate Associates in the organization on regulatory compliance requirements.
- Ensures the organization complies with policies, procedures and practices that accurately reflect the most current regulatory requirements. Assesses current operations making recommendations, executes changes, and monitors effectiveness and adherence.
- Plans and rapidly adopts new and revised requirements. Collects, analyzes, and reports data in support of continuous compliance audit readiness activities.
- In collaboration with the Compliance Officer, is responsible for the monitoring of CHP’s Compliance Plan, Work Plan, Risk Plan and Fraud and Abuse Plan.
- Directs organization audits to assist in determining compliance with regulatory requirements. Disseminates audit and surveillance results, as necessary and directs business unit leaders in the development of corrective action plans and reports results to Senior Leadership.
- Provides continuous gap analysis; develops and manages project plans designed to identify, track and close gaps.
- Responsible for researching applicable federal and state laws and legislation (including House bills and Senate bills).
- Serves as a back-up to oversight function under the Compliance Officer.
- Performs other duties as assigned.
- High School Diploma or General Education Development (GED) required
- Bachelor's degree OR four (4) years of experience in a directly related field required
- Graduate degree preferred
- Excellent verbal and written communication skills.
- Highly organized and able to prioritize tasks with little to no notice.
- Minimum eight (8) years of process improvement, management consulting, change management, or related business experience
- Health care or insurance experience preferred
- Certified in Healthcare Compliance (CHC) Preferred