Vice President of Compliance, Mass General Brigham Health Plan

Site: Mass General Brigham Health Plan Holding Company Inc.

Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham we are on the forefront of transformation with one of the worlds leading integrated healthcare systems. Together we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds experiences and skills.

We are pleased to offer competitive salaries and a benefits package with flexible work options career growth opportunities and much more.

Responsible for the strategic leadership design and oversight of the organizations enterprise compliance program across all lines of business including Commercial Medicaid Medicare Advantage and Dual Eligible Special Needs Plans (DSNP). Ensures the organization maintains full compliance with all applicable federal and state regulatory requirements while fostering a culture of ethics integrity and accountability.

This role provides executive leadership for compliance governance risk mitigation auditing and monitoring and regulatory engagement and partners closely with senior leadership and the Board of Directors to ensure proactive identification and management of compliance risks.

• Develop and lead a comprehensive enterprise-wide compliance program aligned with regulatory requirements and business strategy.
• Establish and maintain compliance governance structures including executive-level committees and Board of Directors reporting.
• Ensure integration of compliance across all lines of business (Commercial Medicaid Medicare Advantage DSNP).
• Drive continuous improvement of the compliance framework in response to regulatory changes and organizational priorities.

• Provide oversight of compliance with federal and state healthcare regulations including CMS Medicaid and commercial requirements.
• Lead enterprise risk assessment processes to identify prioritize and mitigate compliance risks.
• Ensure alignment with accreditation standards and regulatory expectations across all products.
• Stay current on regulatory changes and proactively guide operational leadership on implications.

• Oversee enterprise compliance auditing and monitoring activities including vendor and FDR oversight where applicable.
• Ensure implementation of corrective action plans and validation of remediation effectiveness.
• Lead or oversee investigations into potential compliance violations coordinating with Legal as appropriate.
• Ensure reporting mechanisms (e.g. hotline internal reporting) are effective and trusted.

• Establish and maintain enterprise compliance policies and standards.
• Lead development and execution of compliance education and training programs across all employee populations.
• Partner with Learning & Development on training program training creation and delivery.
• Promote a culture of compliance ethics and accountability across the organization.
• Ensure leaders are equipped to operationalize compliance requirements within their functions.

• Serve as a trusted advisor to executive leadership on compliance and regulatory matters.
• Present compliance program performance risks and key issues to executive leadership and the Board of Directors.
• Act as primary liaison with regulatory agencies during audits reviews and investigations.
• Partner cross-functionally with Legal Operations Clinical Finance and HR to ensure compliance integration.

• Build lead and develop a high-performing compliance organization including regulatory Medicare/Medicaid compliance and audit functions.
• Establish clear goals performance expectations and talent development strategies.
• Foster an inclusive high-accountability culture aligned with organizational values.
• Hold self and others accountable to meet commitments.
• Focuses on collaboration and connection to contribute to a high performing workplace.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

• Bachelors degree in Healthcare Administration Public Health Law Business or related field required or the equivalent combination of training and experience plus 12 years of related experience.
• Masters degree or JD strongly preferred.
• 12 years of progressive experience in healthcare compliance regulatory affairs or risk management
• 7 years of leadership experience in a complex multi-line healthcare organization or health plan
• Deep expertise across government programs (Medicare Advantage Medicaid DSNP) and commercial products
• Experience interacting with regulatory agencies and leading audits and investigations

The salary range for this position is $250000.00 to $300000.00 annually. At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation package.

In addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Hybrid

399 Revolution Drive

40

Regular

Day (United States of America)

8925 Mass General Brigham Health Plan Holding Company Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .