Senior Director, Compliance and Contract Management

Job Description

Job Description

Organization Summary:
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Job Summary:
The Senior Director of Compliance and Contract Management ensures that C3 and its participating health centers are compliant with C3’s value-based contracts. This role is crucial in helping C3 manage risk and maintain a positive reputation with all stakeholders. C3 aims to achieve excellence in value-based, Accountable Care Organization (ACO) infrastructure, enhance quality of care, and to bend the cost curve and support the long-term sustainability of value-based care. The Senior Director of Compliance will also provide some regulatory oversight for the subsidiary companies, such as and not limited to, Community Technology Cooperative (CTC) and Community Pharmacy Cooperative (CPC).
This role requires excellent customer service skills. The ideal candidate is a collaborative, process-oriented thinker with strong attention to detail, excellent organizational skills, and a strong interest in healthcare compliance and contract management.

Job Responsibilities:

• Manage C3’s compliance function for its risk contracts, including the MassHealth ACO contract, ACO REACH, and MSSP
• Take all necessary steps to protect C3 and contracted entities from business risks due to insufficient or inadequate compliance functions, policies and/or procedures
• Manage the Policy and Procedure Committee to ensure Compliance Policies and Procedures are complete, accurate, and up-to-date for all lines of business
• Ensure C3 and all subsidiaries are in compliance with applicable internal P&Ps and laws and regulations
• Ensure health centers are compliant with their duties and obligations as it relates to compliance with C3’s risk contract(s); this includes monitoring and identifying solutions to new and changing contract requirements, supporting program communications and completing program deliverables
• Serve as a company resource for compliance and contract-related knowledge, questions, problem solving, and issue resolution
• Stay current on related industry trends / best practices and communicates to stakeholders
• Perform root cause analysis on complex issues that impact program performance and works with other teams to proactively craft and implement solutions
• Serve as a designated key contact / liaison with government agencies, including MassHealth and CMS, for compliance related issues, including scheduling and participating in meetings and other initiatives relative to our ability to properly function as an ACO
• Oversee Board Compliance Committee activities
• Oversee the compliance activities for subsidiary companies
• Participate in the CTC Privacy Taskforce to support health centers, as appropriate
• Serve as direct supervisor for Compliance team
• Other special projects and duties as assigned

Required Skills:

• Strong healthcare compliance and contract management knowledge and experience
• Demonstrate the ability to synthesize and communicate complex information verbally and in writing
• Possess business acumen for ensuring effective policies, procedures, and processes are established, documented, and implemented
• 5-7 years of professional experience in healthcare compliance, ideally with some Medicaid (or Medicare) experience
• Prior contract management experience
• Experience managing multiple competing priorities; excellent prioritization skills
• Strong analytical and organizational skills including ability to analyze data to identify trends and communicate them through effective reporting methods
• Close attention to detail
• Excellent oral, written, and verbal communication skills including experience presenting compliance information to senior leaders
• Skilled in exercising a high degree of initiative, judgement, discretion and decision making to achieve objectives
• Track record of success as part of multidisciplinary teams that share and leverage the strengths of diverse members
• Quick learner with customer service mindset
• Proficiency in Microsoft applications (Word, Excel, PowerPoint, Outlook)

Desired Other Skills:

• Familiarity with the MassHealth ACO program
• Familiarity with Medicare programs
• Familiarity with Federally Qualified Health Centers
• Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Qualifications:

• Juris Doctor (JD) or Master’s Degree in a related field preferred but not required (public health, public policy, healthcare management)
• Candidates with significant legal, compliance, or regulatory experience will also be considered

** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **