[Remote] Sr. Compliance Principal at Included Health

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's degree with 12 years of relevant experience, or a Master's degree with 8 years of experience, or a PhD with 5 years of experience, or equivalent combination of education and experience
Extensive knowledge of theories, practices, and design matters related to healthcare compliance
Significant experience developing and leading critical, strategic initiatives within a compliance program
Experience applying healthcare compliance expertise
Experience creating formal networks and coordinate among groups to influence important partners across the organization
Experience with conceptual thinking to understand advanced issues and their possible effects
Recognized internally as a subject matter expert
Expert-level understanding of healthcare laws, regulations, and ethical standards, including HIPAA, CCPA, ACA 1557, the False Claims Act, and the Anti-Kickback Statute
Experience developing and administering compliance audits and an understanding of data collection, analysis, and reporting mechanisms to monitor compliance efforts
The capacity to analyze complex data, interpret regulations, and develop effective solutions to intricate compliance issues

Responsibilities

Lead and contribute to the development of goals and principles in creative and effective ways
Apply broad expertise to address significant and unique compliance issues, using conceptual thinking to understand advanced issues and their possible effects
Be an internal subject matter expert, providing expertise on broader organization projects that require an understanding of the wider business
Identify and assess significant and unique compliance risks, including those related to regulatory compliance, HIPAA Privacy, billing and coding/revenue cycle, and federal/state health insurance programs
Design and implement long-term risk mitigation strategies, exercising independent judgment in the methods, techniques, and evaluation criteria for obtaining results
Conducting risk assessments and developing corrective action plans
Provide strategic guidance and oversight for monitoring and auditing activities, using insights from these findings to inform future program design and long-term preventative measures
Serve as the enterprise-wide subject matter expert, conveying advanced information and persuading diverse team members and audiences
Create formal networks involving coordination among various groups to achieve compliance goals
Work on issues where the analysis of situations or data requires an evaluation of intangibles, with accountability for results that may affect the entire function

Skills

Included Health

Healthcare advocacy and specialized care services

About Included Health

Included Health focuses on enhancing the healthcare experience for individuals who often face challenges in accessing quality care. The company provides a variety of services, including primary care, behavioral health, and virtual care, ensuring that members receive timely and appropriate treatment. Their model emphasizes 24/7 on-demand care with a diverse group of providers, allowing for personalized support tailored to complex health needs. Unlike many competitors, Included Health prioritizes underserved populations and partners with employers and consultants to deliver comprehensive healthcare solutions that not only improve health outcomes but also help reduce costs. The ultimate goal of Included Health is to make quality healthcare accessible and understandable for everyone, particularly those who have been overlooked by traditional healthcare systems.

San Francisco, CaliforniaHeadquarters

2020Year Founded

$337.5MTotal Funding

GROWTH_EQUITY_VCCompany Stage

HealthcareIndustries

51-200Employees

Benefits

Along with comprehensive medical, dental and vision plans; all employee spouses and children can access Included Health services at no cost. For time off, take it when you need it with our unaccrued discretionary time off for all exempt employees.

Risks

Competition from Teladoc and Amwell threatens market share.

Post-merger integration challenges could affect service delivery.

Regulatory scrutiny on telehealth may impact operational flexibility.

Differentiation

Included Health offers integrated primary and behavioral health services.

They provide 24/7 on-demand care with diverse providers.

Their data-driven approach enhances healthcare outcomes and reduces costs.

Upsides

Rising demand for telehealth boosts Included Health's virtual care services.

Employers investing in healthcare benefits expand Included Health's client base.

Value-based care models align with Included Health's focus on outcomes.

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