VP, Compliance

Alignment Health is breaking the mold in conventional health care committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we this fast-growing company you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters not only changing lives but saving them. Together.

Job Responsibilities:

Lead and Evolve the Enterprise Compliance Program. Design implement and continuously enhance and mature a comprehensive data-driven risk-based Compliance Program aligned with CMS and State requirements and organizational strategy. Serve as the overall owner of the Compliance Plan and all program documentation driving annual review and updates to reflect the regulatory landscape and Business growth objectives.

Provide Strategic Regulatory Guidance to Executive Leadership. Monitor interpret and communicate emerging and enacted regulatory and enforcement requirements and trends to the Chief Compliance Officer and senior management. Translate complex regulatory requirements into clear actionable business strategies enabling proactive timely and risk informed decision making across the enterprise.

Drive Compliance Monitoring Auditing and Reporting. Oversee the design and execution of compliance monitoring and auditing plans ensuring data-driven actionable insights and executive-level reporting. Establish dashboards and reporting that enable real-time visibility in compliance risk control effectiveness and program performance.

Investigations. Direct the investigation of compliance violations and allegations of HIPAA privacy breaches ensuring they are consistent defensible and aligned with Alignment and regulatory expectations. Maintain investigation logs and escalation pathways including board-level escalation where appropriate.

Govern HIPAA Privacy and Data Protection Compliance. Ensure organizational adherence to HIPAA privacy and security rules including oversight of privacy incident response breach notifications and remediation plans. Partner with IT Legal and operational leaders to embed data protection standards into business processes and technology platforms.

Champion Compliance Training and Culture. Oversee compliance education programs ensuring it is strategically aligned role based and measurable in effectiveness. Promote a culture of accountability speak-up culture and ethical decision making.

Compliance Policies. Lead the development revision and organization-wide communication of compliance and HIPAA policies ensuring clarity legal alignment and operational usability. Coordinate with cross-functional partners to integrate compliance requirements into business workflows contracts and vendor relationships.

Team Leadership. Develop retain and recruit when appropriate a high caliber scalable Compliance organization. Create clear succession pipeline as #2 to the Chief Compliance Officer.

Job Requirements:

Experience:

Required:

• Significant MAO Compliance leadership experience (5 required - 10 years preferred) interfacing with CMS and State regulators related to audits and enforcement actions as well as internal and external business partners.
• Experience operating within a complex fast-scaling enterprise health plan or value-based care organization.

Preferred:

• Experience in an MAO undergoing rapid growth integration or transformation.
• Prior experience directly supporting a Chief Compliance Officer or serving in a #2 Compliance leadership role with Board-level exposure.

Education:

Required: Bachelors degree in Healthcare Administration Legal Studies Business Public Health or a related field; or equivalent professional experience in lieu of degree.

Preferred: Advanced degree (or equivalent graduate-level education in a compliance-adjacent discipline.

Specialized Skills - Emphasis on

• Data Analytics/Compliance Intelligence
• Enterprise Risk Alignment
• Executive-level communication engagement and collaboration

• Compliance Management (Advanced) Ability to monitor and assess systems to ensure adherence to industry standards corporate policy and regulatory requirements; establish frameworks for adherence conduct audits and implement corrective measures.
• Regulatory Compliance (Advanced) Deep understanding of organizational adherence to laws regulations and guidelines relevant to Medicare Advantage healthcare operations including CMS OIG and state regulatory frameworks.
• Health Care Risk Management (Advanced) Identifying assessing and managing risks in the healthcare industry; knowledge of healthcare laws and regulations patient safety and organizational risk mitigation.
• Compliance Reporting (Advanced) Ability to systematically collect organize and present information to demonstrate adherence to legal and regulatory frameworks with meticulous record-keeping and effective communication of compliance status.
• Health Laws (Advanced) Specialized knowledge of the legal and regulatory requirements related to healthcare services including patient care medical records insurance HIPAA and healthcare policy.
• Incident Reporting & Investigation (Advanced) Skilled in documenting communicating and managing compliance incidents with ability to lead complex investigations and maintain audit-ready records.
• Ethical Judgment & Integrity (Advanced) Necessary to uphold organizational values maintain trust in adherence to legal and organizational policies and model ethical conduct throughout the compliance function.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job the employee is regularly required to talk or hear. The employee regularly is required to stand walk sit use hand to finger handle or feel objects tools or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay range may be based on a number of factors including market location education responsibilities experience etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability age protected veteran status gender identity or sexual orientation.

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