Director, Corporate Compliance

Who We Are

At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our mission - and our passion - is to improve the lives of the members we serve and be the ideal partner for our providers.

Lucet's unique combination of people and technology has proven to optimize access to behavioral health care providers and increase a health plan's ability to connect members to quality care. With the industry's largest network of care navigators and technology powered by more than six million assessments and more than 20 years of data, Lucet is the only solution proven to successfully identify and connect people across the entire acuity spectrum with the right care in less than five days on average, and often as little as one day.

Our members, providers and partners fully entrust us to deliver outstanding quality care through coordinated behavioral health services, employee assistance programs, organizational consulting, student well-being programs and more.

When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.

Job Summary

The Director, Corporate Compliance, promotes a culture or ethics and integrity across Lucet by serving as an in-house subject matter expert for regulatory matters and health plan compliance operations, including Medicare Advantage, self-funded groups, imbedded EAP/MBH products. The Director oversees the general direction and strategy for the Corporate Compliance Department and the Corporate Compliance team to ensure proper enforcement of compliance standards via leadership of the department. The Director is responsible for multiple high-level Corporate Compliance activities including regulatory compliance, contractual compliance, compliance training, communication/letter compliance, enterprise risk management, and government health product compliance.

Essential Functions

• Compliance Program Oversight
• Oversee organizational communications required by laws, regulations, and accreditation standards, to ensure all communications accurately reflect all applicable requirements and plan preferences.
• Ensure compliance with regulatory and internal requirements while serving as a liaison to Lucet's Quality Department to support the implementation and adherence to URAC and NCQA accreditation standards.
• Support the creation and delivery of content for the mandated quarterly Corporate Compliance Committee meeting and report on the various activities of subcommittees and/or workgroups hosted by the Corporate Compliance Committee.
• Responsible for the Corporate Compliance communications plan.
• Assist with the development of program success measures and perform periodic assessments of program success.
• Support the creation and review of RFP response content.
• Leadership
• Lead and mentor a high-performing team fostering a collaborative work environment monitoring the performance of direct reports and providing prompt and objective coaching and counseling. Conduct performance reviews and recommend compensation.
• Maintain working relationships with Lucet leadership to be the trusted primary functional point of contact for Compliance.
• Oversee the management of the compliance department's day to day activities with the anticipation of periodic reporting to the VP, Compliance, SVP, Legal & Compliance, and/or CEO.
• Regulatory Liaison
• Participate as Compliance's spokesperson in customer implementations, new operational programs or projects to provide Compliance/ Medicare Compliance input and support.
• Serve as a subject matter expert in accreditation and Medicare Advantage rules, regulations and guidelines. Collaborate with operational areas to ensure proper interpretation and execution of these standards. Support Health Plan customers in their MHPAEA NQTL comparative analysis.
• Support the Compliance Officer and acts as a primary compliance liaison with health plan compliance counterparts for day-to-day duties.
• Ensure timely and accurate reporting to regulatory bodies.
• Audits and Investigations
• Collaborate and communicate with leadership included in a particular audit, the expectations of the audit, and the potential implications of that audit.
• Oversee all site visits from regulators and/or clients and ensure any needs are addressed.
• Coordinate, oversee, and respond to compliance audits including internal Corporate Compliance audits and external audits to ensure compliance with governmental and internal requirements.
• Initiate and support communication of audit results in both written reports and verbal discussions with Compliance leadership and business owners including corrective action plans (CAP) or continuous improvement plans identified through audits, monitoring departmental performance indicators, or by recommendation of business owner, management or the Board of Managers.
• Lead coordination of all compliance program investigations, review of disciplinary actions, and implementation of CAP considering the business justification, and the implications for Lucet, Lucet health plan customers, and Lucet ownership. Follow through on corrective action plans or continuous improvement plans until operational areas meet standards.
• Collaborate with other areas of the business to direct compliances to appropriate existing channels for investigation and resolution.
• Serve as a review body to ensure that compliance issues/concerns/alleged violations of policy and procedure/law/regulations within the company are being appropriately evaluated, investigated, addressed, and resolved.
• Risk Management
• Independently identify compliance gaps, weaknesses and deficiencies and begin the process improvement and efficiency initiative to remediate those in consultation with the Compliance Officer.
• Assist the Compliance Officer in monitoring key performance indicators to assess operational risks.
• Remain aware and understand industry changes and/or trends including Mental Health Parity, healthcare privacy, AI technology, and governance.
• Maintain continual responsibility for managing customer health plan expectations relative to compliance deliverables and meeting compliance specific deadlines.
• Policy and Procedure Oversight
• Oversee the development and implementation of compliance policies and procedures. Establish program governance when needed under the guidance of the Compliance Officer.
• Evaluate policies and procedures with corresponding desk level procedures to ensure CMS guidance for compliant operational activities remain properly documented.
• Monitor and track changes for relevant CMS requirements and works with operational area(s) to identify changes to current procedures.
• Demonstrate subject matter expert understanding of operational processes and controls.
• Edit, write, standardize, research, and approve policies and procedures, training manuals and supporting documentation for compliance and other internal departments.
• Ensure effective dissemination of policies across the organization.
• Adhere to Lucet's mission statement, core values and behaviors, Code of Ethical Business Conduct, and Compliance Program.
• Comply with all federal and applicable state and local laws and Lucet policies and procedures regarding privacy, confidentiality, and security of health information, and other designated information.
  
  
  

Required

Job Qualifications

• Bachelor's degree or equivalent.
• 8+ years of experience in compliance, Medicare compliance, Managed Behavioral Health Care, audit or as a business analyst.
• 3+ years of experience leading a team of direct reports
• Certified in Health Care Compliance (HCCA) or equivalent (CHC)
• Certified in Health Care Privacy Compliance (HCCA) or equivalent (CHPC)
• Strong knowledge of CMS, Medicare Advantage, Medicare Managed Care Manual, HIPAA, and other federal and state health care regulatory compliance regulations.
• Demonstrated ability to effectively train, motivate and lead others.
• Experience with coordinating and leading projects.
• Highly organized, quick learner, detail oriented.
• Demonstrated ability to design and deploy training and educational materials.
• Works with a professional demeanor under pressure.
• Capable of leading team, peers, and leadership to resolve issues and motivate others.
• Proficient with Microsoft Office (Word, Excel, Power Point and Outlook).
• Ability to travel up to 10% of the time.
  
  
  

Preferred

• Master's Degree or equivalent.
• Experience in Managed Behavioral Healthcare compliance.
• Experience developing effective relationships with federal and state regulatory agencies and customers.
  
  
  

Key Competencies

• Ability to manage diverse administrative functions with complex and competing priorities.
• Ability to think critically and apply information to improve processes.
• Self-disciplined with ability to manage time, prioritize and multi-task.
• Ability to work collaboratively within teams and autonomously and independently.
• Thrives on change and readily accepts new assignments and challenges.
• Excellent communication skills to include effective presentation skills, listening skills, and verbal and written communication
• Strong analytical and problem-solving abilities.
• High level of accuracy and attention to detail.
• Responsible
• Intuitive nature to identify compliance irregularities
  
  
  

Working Conditions

• Work is performed indoors in a remote, home setting or typical office environment - not substantially exposed to adverse environmental conditions.
• Frequent exposure to VDT screens, video calling, headphones, and computers.
• Physical demands include constant ability to remain in a stationary position, move about inside an office or remote setting, able to communicate and exchange information with others, able to inspect information, and able to perform repetitive motion with arms and fingers.
• Mental demands include constant ability to interpret data, problem solve, make decisions, and organize and plan.
• Travel required across state lines to include overnight stays up to 10% of time.
  
  
  

Salary and Other Compensation:

The starting salary that Lucet reasonably expects to pay for this position ranges from $145,000 - $170,000 annually, depending on circumstances including an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.

This position is eligible for a bonus in accordance with the terms of Lucet's incentive plan based on both company performance and individual performance. 

Benefits: The Company offers the following benefits for this position, subject to applicable eligibility requirements: Medical, Dental, Vision, 401(k) with competitive employer match, company paid life and disability insurance, company paid gym access, tuition reimbursement, parental leave, PTO (vacation, sick and volunteering), Remote Work.

This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.