Director of Policy and Compliance
Department:
Administration
Reports to (title):
CEO
Supervises:
None
Classification:
Exempt
PERFORMANCE EXPECTATIONS
In performance of their respective tasks and duties all employees of BeWell are expected to conform to the following:
- Uphold all principles of confidentiality to the fullest extent.
- Adhere to all professional and ethical behavior standards of the healthcare industry.
- Interact in an honest, trustworthy and respectful manner with participants, employees, visitors and vendors.
- Comply with New Mexico Health Insurance Exchange’s policies and procedures.
POSITION PURPOSE
The Director of Policy and Compliance is a leadership role responsible for developing, implementing, and overseeing policies, procedures, and initiatives. This position is responsible for analyzing and interpreting federal and state regulations impacting the organization ensuring compliance through assessments and risk mitigation strategies. They will also collaborate with HR to ensure employee policies and procedures adhere to legal and regulatory guidelines and oversee all Board policies on behalf of the Exchange.
Essential Duties, Functions & Responsibilities
- Policy is defined in this title as: internal policies for NMHIX, Board policies, tracking of state policies, statute changes and proposed/passed law changes. Policy also includes monitoring federal policy changes and trends in other states that may impact or be replicated in New Mexico.
- Compliance is defined in this title as: Monitor compliance regulations and deadlines for submissions for local, state and federal laws. Compliance also covers needed trainings for internal staff. Compliance includes Board compliance and monitoring of action item tracking, Board positions and term dates, Board compliance training and financial disclosures.
- Develop and maintain relationships with external research organizations, universities, and governmental entities focused on research and policy analysis
- Prepare periodic analyses and briefings for executive team regarding changes in state and federal policy
- Work collaboratively with executive team to monitor, review, and respond to federal state, and local policies.
- Manage various BeWell policy and compliance publication cycles, including the annual policy manual
- Coorrdinate timelines and collaborate with staff to respond to proposed federal and state regulations.
- Serve as the primary contact for CMS inquiries regarding various federal requirements and required data points
- Prepare ad-hoc regulatory reports and other deliverables
- Serve as the policy lead for any IT system implementations or changes
- Serve as the organization’s designated Records Custodian, including overseeing all responses to IPRA requests and Financial Impact Reports during legislative sessions
- Actively monitors legislative sessions, handles bill tracking and committee appearances for the organization
- Develop and manage Memorandums of Understanding (MOUs) and other agreements with partner organizations, including state and federal agencies
- Represent BeWell in external presentations, including to the Legislature, advocacy organizations, education groups and at major conferences, as requested
- Ensure the organization complies with relevant standards and current organizational and legal requirements
- Ensure delivery of privacy training and orientation to employees, volunteers, professional staff, contractors, alliances, business associates and other appropriate parties.
- Review and monitor contracts for compliance with applicable privacy requirements, and work with the Chief Information Officer, as applicable, to ensure all privacy concerns, requirements, and responsibilities are addressed.
- Coordinate with management the development of procedures for documenting and reporting self-disclosures of any evidence of privacy violations.
- Oversee NMHIX Board policies, term limits and appointments. This includes draft language for board policy updates and changes and implementation in updating policies.
- Create and maintain internal NMHIX policies, reviewing them annually.
- Performs other related duties as assigned.
MINIMUM MANDATORY QUALIFICATIONS
Experience:
- 2-5 of experience working in policy, compliance, risk management, employment law, or related roles, with demonstrated knowledge of federal, state, and local regulations.
- Strong understanding of policy and compliance frameworks, risk assessment methodologies, and internal control practices.
Education
- Bachelors in public administration, business management, public policy or similar field
Mandatory Knowledge, Skills, Abilities and Other Qualifications:
- Detailed knowledge of the Affordable Care Act (ACA), the New Mexico Health Insurance Exchange Act (NMHIXA) and/or some experience in Medicaid eligibility preferred
- Familiarity with policy development and implementation
- Develop guidance documents
- Ability to professionally articulate orally and in writing an understanding of complex issues and detailed action plans
- Excellent organizational skills
- Ability to successfully complete required training on BeWell systems
- Ability to multi-task, set priorities, and manage time effectively
- Superior written and verbal communications skills and the ability to handle sensitive and confidential situations
- Detailed Knowledge of the provisions and protections afforded by the Affordable Care Act (ACA) and the New Mexico Health Insurance Exchange Act (NMHIEA)
- Strong interpersonal and relationship-building skills with a proven ability to build and maintain positive, effective relations
- Strong phone and verbal communication skills, as well as active listening skills
- Effective problem-solver with the ability to develop and advance alternative solutions
- Able to work in a team-oriented environment and effectively communicate both verbally and in writing
- Ability to effectively report on the status and implementation of projects to senior management
- Excellent ability to conceptualize long-term business goals and develop orderly processes to accomplish those goals.
- Excellent managerial skills.
- Thorough understanding of information technology and information technology systems.
- Knowledge of Microsoft Office Suite; Microsoft Word; Microsoft PowerPoint; Microsoft Excel and internet software
- Use of Windows Explorer (electronic file-handling)
- A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers
WORK ENVIRONMENT
Office environment:
The work environment characteristics described here are representative to those an employee encounters while performing the primary functions of this job. Normal office conditions exist, and the noise level in the work environment can vary from low to moderate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the primary functions of this job. While performing the duties of this job, the employee may be required to frequently stand, walk, sit, bend, twist, talk, hear and perform repetitive motions. There may be prolonged periods of sitting, keyboarding, reading, as well as driving or riding in transport vehicles. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include reading, distance, computer, and color vision. Talking and hearing are essential to communicate with patients, vendors and staff. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Mental demands:
There are a number of deadlines associated with this position. The employee must be able to handle frequent interruptions and must also multi-task and interact with a wider variety of people on various and, at times, complicated issues.
OTHER
Confidentiality:
All employees must uphold all principles of confidentiality to the fullest extent. This position has access to sensitive information and a breach of these principles will be grounds for Immediate termination.
Background Investigation:
This position may be subject to a criminal history background check, a suitability background check and/or a Fair Credit Reporting Act (FCRA) check. Candidates must be able to successfully pass all required background checks to qualify for this position.
Disclaimer: The information on this position description has been designed to indicate the general nature and level of work performance by employees in this position. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position. Employees will be asked to perform other duties as needed. In order to provide equal employment and advancement opportunities to all individuals, employment decisions at the New Mexico Health Insurance Exchange will be based on merit, qualifications, and abilities. The NM Health Insurance Exchange does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability or any other characteristic protected by law.
Job Type: Full-time
Pay: $96,470.00 - $120,588.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Professional development assistance
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Ability to Relocate:
- Albuquerque, NM 87109: Relocate before starting work (Required)
Work Location: Hybrid remote in Albuquerque, NM 87109