Sr. Director, Regulatory Compliance
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About The Position
The Sr. Director of Regulatory Compliance at HealthEdge Software Inc. is a pivotal role that requires a subject matter expert in healthcare regulatory and compliance. This position is designed for an individual who possesses a strong acumen and passion for leveraging innovative technology to address critical needs in the healthcare sector. Reporting directly to the Chief Medical Officer, the Sr. Director will ensure that HealthEdge's clinical suite of products, including GuidingCare and Wellframe, effectively support health plan customers in achieving and maintaining compliance with various regulatory bodies such as the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid Services (CMS), the Utilization Review Accreditation Commission (URAC), and other state regulatory agencies. The ideal candidate will have a comprehensive understanding of healthcare compliance requirements across multiple regulatory frameworks, alongside a deep knowledge of clinical software programs. This role involves discerning the vendor's role in regulatory compliance and proactively monitoring and interpreting regulations to provide expert insights relevant to HealthEdge's customers and software solutions. The Sr. Director will collaborate with various stakeholders, including the enterprise legal and compliance team, to identify and document clinical regulations pertinent to HealthEdge products, ensuring that compliance requirements are effectively communicated to all stakeholders. In addition to monitoring compliance, the Sr. Director will be responsible for identifying areas of non-compliance within applications and services, analyzing potential risks, and developing action plans to address any gaps. The role also includes the development of a compliance scorecard to monitor adherence to compliance standards and the creation of periodic regulation update briefs for internal use. The Sr. Director will act as a subject matter expert on relevant legislation and regulations, ensuring that changes are communicated clearly to customers through various channels, including user groups and one-on-one sessions. This position is crucial for maintaining HealthEdge's credibility in the market and advancing organizational alignment with regulatory requirements.
