If you’re interested in a career within a customer-focused, team-oriented environment that rewards innovation, quality, integrity and collaboration, MedImpact Healthcare Systems, Inc. welcomes your application. MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
The VP, Corporate Compliance Officer provides strategic and operational leadership pertaining to compliance and regulatory issues as well as oversees an enterprise wide comprehensive compliance program including but not limited to a Medicare Part D Compliance Program. The position oversees the development of a compliance risk management program to assess, prioritize, and manages legal and regulatory compliance risks based on state/federal guidelines and requirements and benchmarking research, facilitating the systematic assessment and management of compliance risks. The role is also responsible for enterprise-wide confidential reporting systems allowing employees, customers, contractors, and other stakeholders to disclose violations of the corporation's ethical standards, violations of law, or corporate policy relating to such matters without fear of retaliation. MedImpact and its subsidiaries offer full-spectrum PBM services and the position is responsible for oversight of the parent and its operating subsidiaries.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Responsible for development, implementation and ongoing refinement of enterprise-wide strategies for an effective compliance, ethics and integrity and privacy/security program
Oversight of a robust Medicare Part D Compliance Program
Provides leadership and oversight of compliance monitoring and auditing activities (i.e., compliance assurance program), including any action plans and/or commitments made by enterprise
Develops, directs and maintains responsibility for the corporation's compliance function and business ethics related to standard of conduct, including HIPAA/HITECH privacy and security compliance
Reviews the content and performance of the Corporate Compliance Program including Medicare Part D, compliance policies and procedures, and the Corporate Code of Business Conduct and Ethical Behavior on a routine basis and takes appropriate steps to ensure its effectiveness to prevent, detect and correct illegal, unethical, or improper conduct within the corporation
Manages any investigations of alleged violations of law, policies and procedures, and the Company’s Code of Conduct in consultation with the SVP, Corporate Services and General Counsel, and/or designated outside legal counsel, and takes appropriate corrective action
Oversees the [development, implementation and] maintenance of an effective compliance communication and training program for the enterprise, subsidiaries and affiliate entities
Coordinates with various departments, such as Legal, Human Resources, Operations and other departments as required, and include appropriate introductory compliance training, as well as ongoing training on compliance related topics as needed
Provides real-time guidance to business units and subsidiaries related to multiple potential compliance issues
Effectively translates regulatory guidance into streamlined operational processes to ensure compliance, at times with short notice
Manages the development and operation of the organization’s compliance hotline and works with the SVP, Corporate Services and General Counsel and/or designated outside legal counsel to resolve legal compliance issues, and works with Human Resources to resolve employee-related issues, as appropriate
Oversees the development and operation of compliance monitoring and auditing (i.e., compliance assurance program)
Receives regular reports and assists in the development of corrective actions
Serves as Chair for the Corporate Compliance Committee, which serves in an advisory capacity, and keeps senior management informed on the operation and progress of the organization’s compliance efforts
Designs and implements programs, policies, and practices to ensure that all business units are in compliance with federal, state, and local regulatory requirements
Tracks laws and regulations that affect the organization's policies. Prepares compliance reports for presentation to the Board of Directors and executive management
Directs the coordination and completion of all government, regulatory, and compliance documents on an enterprise level and oversees the acquisition and maintenance of required licenses and certificates from appropriate state and federal entities
Provides day to day management of the department (directly and through subordinate managers) including developing and managing the department’s budget
Recruits, manages, develops and retains the necessary resources to successfully perform the Corporate Compliance function
Manages large scale projects and initiatives to completion by utilizing internal resources or identifying external resources, vendors, etc.
Education and/or Experience
For consideration, candidates will need a Bachelor’s degree in a business, health care or related area of study required (or equivalent combination of education and experience); An advanced degree is preferred.
Ten (10) years’ job related management experience in the PBM environment. Candidates with other healthcare experience (health plans, state Medicaid plans) may be considered but PBM experience is most important.
Compliance experience at a national level is preferred and experience with Medicare Part D is required
Must have at least 5 years of HIPAA compliance expertise and prior responsibility as a Privacy Officer and/or Security Officer preferred
Five (5) years of leadership experience managing a team or department
Experience with broad spectrum PBM offerings and associated potential regulatory issues is a must
Solid computer skills with Microsoft Office/Outlook, industry-related databases and use of the internet
Certificates, Licenses, Registrations
Certified Compliance and Ethics Professional or Certified in Healthcare Compliance (CHC) required or agreement to obtain within first 1-2 years of employment
Other Skills and Abilities
Excellent interpersonal, collaborations, communication, (verbal and written) and presentation skills essential
Ability to lead and facilitate group meetings as well as experience presenting to senior leaders of the organization
Self-starter with the ability to define, coordinate and direct assignments of team members
Knowledge of Medicare/Medicaid and related healthcare rules and regulations, such as third party administrator and utilization review
This position is located in San Diego, California and may require domestic and international travel
This position is eligible for Employee Referral Bonus at Level III
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
Internal Number: 500.181113.5858
About MedImpact Healthcare Systems
MedImpact Healthcare Systems, Inc. is a Pharmacy Benefits Management (PBM) company focused on delivering straightforward, cost-efficient and clinically effective prescription drug management for clients. As a PBM headquartered in San Diego, CA, MedImpact traditionally processes pharmacy claims and provides clinical support to effectively manage the complexities of the drug benefit. MedImpact provides superior outcomes to those we serve through innovative solutions, systems, and services that provide transparency and promote choice in decision making. Currently serving more than 32 million members nationwide, MedImpact is the PBM of choice for 8 of the top 10 HMOs in the country, as rated by Consumer Reports in 2009.