Director, Compliance Officer Resume Sample
Caden Simonis
125 Pouros Ridge,
New York,
NY
+1 (555) 106 2962
Work Experience
Director, Compliance Officer
09/2017
-
PRESENT
New York, NY
- Serve as the Market’s subject matter expert on the conditions and terms of WellCare’s federal and state contracts
- Partner with WellCare’s Internal Audit Department on Market-based assessments
- Serve as the local compliance and oversight contact for Compliance applications (LIONS, C360)
- Monitor contract uploads in Corporate Compliance system to ensure all requirements documented including amendments, handbooks, policy transmittals and statutes
- Direct the establishment and maintenance of a corporate compliance and ethics program that meets federal guidelines as well as other stakeholder requirements; maintain the code of conduct, monitor regulatory compliance, maintain the anonymous hotline and post office box and respond to employee questions and concerns about the compliance and ethics program or any of its components
- Assist the Senior Director, Market Compliance Officer with the implementation and oversight of the policies, procedures and practices designed to ensure compliance with the requirements set forth in federal and state Plan contracts, laws, regulations, and health care program requirements
- Establish and lead the Market Compliance Oversight Committee. Ensure meeting minutes are collected and archived
- Complete Market Compliance Assessment – Quarterly Performance Report Work plan and compile Quarterly Performance Report for submission to Market leader and Senior Director, Market Compliance Officer
Director, Ethics & Compliance Officer
09/2014
-
06/2017
Dallas, TX
- Serve as Market subject matter expert for HIPAA, assess compliance with HIPAA requirements, perform or coordinate periodic HIPAA audits of office location(s) and guide remediation plans
- Collaborate with Regulatory Affairs to remain current on state regulations, comply with reporting requirements and serve as an integrated compliance voice during the planning and execution phases of Market programs and projects
- Serve as the Market compliance resource and assist the Senior Director, Market Compliance Officer with monitoring the day-to-day compliance activities at the applicable Market
- Collaborate with Market Regulatory Affairs, Delegation Oversight and Legal departments to monitor vendor compliance. Review delegation oversight tools, subcontracts and provider agreements to ensure they meet regulatory requirements
- Build relationships with key business owners to collect and review operational reports to monitor compliance and communicate risks. Communicate risk information and performance scores to Market leaders, Vice President, Compliance Oversight, Market Regulatory Affairs, Internal Audit, and fellow Market Compliance Officers
- Partner with Compliance Investigation teams, including conducting investigations relative to agent Sales & Marketing and enrollment FWA cases and conducting interviews with potential beneficiaries, members, agents, providers, associates and/or downstream entities as required for investigatory purposes
- Monitors, analyzes, interprets, and communicates regulatory changes related to coding, billing, and collections. Leads and oversees efforts to respond to new or changing regulations, including but not limited to communicating regulations to leadership and affected departments, assembling and chairing work teams
- Supports the process for investigating and addressing internal/external complaints regarding regulatory requirements
- Ensures compliance with existing rules, new rules, regulations and revisions, as set forth by the Center for Medicare and Medicaid Services (CMS), as well as other federal and state laws and regulations that govern matters related to hospital and physician revenue cycle
Director Market Compliance Officer
07/2009
-
08/2014
Philadelphia, PA
- Oversees the follow-up to ensure timely repayment is made for all identified overpayments received from government agencies and patients
- Oversees the development and implementation of compliance policies and procedures related to the organization’s hospital and physician revenue cycle
- Reduces organization risk by identifying risks related to hospital and physician revenue cycle and manage annual work plan to address identified risks
- Contribute to the annual compliance monitoring plan and oversee the components related to hospital and physican revenue cycle activities
- Develops, leads, and directs the Corporate/Entity Compliance programs for the departments and affiliates of Spectrum Health through the coordination of available resources. Collaborates on strategy development for Compliance programs. Implements measures to monitor the effectiveness of the compliance program
- Directs or performs complex investigations of corporate compliance issues and/or works with counsel to determine the appropriate handling of such issues. Directs and oversees resolution of compliance issues referred for investigation
- Oversees internal and external audit procedures for the purpose of monitoring and detecting any misconduct or noncompliance. Coordinates and oversees resolution of issues referred for investigation
- Directs or leads investigations relative to potential fraudulent or illegal activities. Works with internal and/or external legal counsel and external regulatory agencies to resolve such issues. Develops and monitors internal controls designed to detect and/or prevent illegal, unethical or improper conduct by employees, agents, affiliated providers or others within the health system
Education
University of Phoenix - New Mexico Campus
2004 - 2009
Bachelor's Degree in Business
Professional Skills
- Accepting this director/vice president level position requires signing an Agreement Regarding Non-Disclosure of Confidential Information and Non-Competition as a condition of employment
- Proven managerial and group process skills including cross-functional team development in a matrixed environment
- Compliance testing and auditing experience desirable
- Knowledge and experience with hospital specific health care laws and regulations, and hospital inpatient/outpatient coding and billing compliance required
- Previous planning and project management experience
- Experience with at least one or more of the following is required
- Highest ethical standards and share the organization’s commitment to the values under which it operates
How to write Director, Compliance Officer Resume
Director, Compliance Officer role is responsible for organization, compensation, securities, training, integration, auditing, reporting, modeling, insurance, travel.
To write great resume for director, compliance officer job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Director, Compliance Officer Resume
The section contact information is important in your director, compliance officer resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Director, Compliance Officer Resume
The section work experience is an essential part of your director, compliance officer resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous director, compliance officer responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular director, compliance officer position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Director, Compliance Officer resume experience can include:
- Responsible for knowledge and interpretation of various rules, regulations and standards that impact healthcare delivery; in consultation, as necessary, with legal counsel. Responsible for communicating such rules, regulations, and standards to Hospital management and staff through a variety of means
- Develops capital and/or operational budget to support the compliance management program. Routinely monitors, manages and controls budget, analyzes variances and takes appropriate action as indicated
- Establishes, implements, and maintains objectives or process improvement protocols pertaining to compliance. Administers, develops and maintains departmental and administrative policies, procedures and methodologies
- Coordinate with the business to ensure effective controls are in place to meet federal and state laws; provide advice to management on how to comply with the laws and regulations; monitor the business units’ performance with compliance, alert management to compliance gaps and issues, and assist with responses to regulatory exams
- Act as a change-agent through directing, influencing, mentoring and modeling
- Maintain and execute the enterprise Volcker Compliance Program, including maintaining the Volcker enterprise policy and standards
Education on a Director, Compliance Officer Resume
Make sure to make education a priority on your director, compliance officer resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your director, compliance officer experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Director, Compliance Officer Resume
When listing skills on your director, compliance officer resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical director, compliance officer skills:
- Able to effectively provide guidance and direction to less-experienced staff and demonstrates well-developed leadership skills
- Strong backbone and able to effectively influence senior leaders and other layers of management. Excellent communication and interpersonal skills
- Proven experience in identifying and resolving compliance, legal or regulatory issues quickly and effectively
- Strong problem solving, analytical negotiation and skills
- Demonstrates ability to effectively working cross-culture/cross-borders
- Excellent verbal and written communication skills in English are required. Fluency in French or other European language is useful
List of Typical Skills For a Director, Compliance Officer Resume
1
Skills For Director, Ethics & Compliance Officer Resume
- Specific knowledge of medical spending account operations including claim payment, enrollment, sales and marketing, and appeal and grievances
- Working within investment management within a legal, compliance or business unit in a financial services firm offering private funds and annuities
- Collaborate with the Compliance testing team to develop testing of the Volcker program on a risk-based basis
- Assist the firm in implementing corrective actions as identified by the compliance program
- Conduct oversight and testing to evaluate company’s international privacy activity
- Actively promotes Tech Data’s Code of Conduct, related policies and procedures and new developments in law or regulation pertaining to compliance
- Responsible for Compliance testing program required by SEC Rules 38a-1 and 206(4)-7 and FRB SR08-08
- Manages Line of Business open issues and management progress on action plans, appropriate escalation and reporting; and
- Key capabilities also include executive presence, delivering results, teamwork, collaboration (in a matrixed environment), and external focus
2
Skills For Director, Market Compliance Officer Resume
- Possess subject-matter expertise and knowledge of Compliance environment, specifically including Animal Health industry
- Broad knowledge of the financial management industry, health insurance and state and federal regulations
- Well-developed written and oral communications skills with the ability to present and explain complex information confidently to clients, regulators and the MII Life Board
- Previous experience with a Volcker or Dodd-Frank Act related compliance program, either within Compliance, Law or Audit or as a business person accountable for Volcker compliance
- Demonstrated management and leadership in compliance and privacy
3
Skills For Director Market Compliance Officer Resume
- Knowledge and experience with all general health care compliance and privacy regulations required
- Series 7 & 24 certifications or the ability to obtain Series 7 & 24 certifications within 6 months is required
- Implements, maintains and updates Tech Data’s Code of Conduct and related Company policies and procedures to ensure currency and clarity and with the goal of preventing illegal or unethical conduct
- Oversees, manages and further develops Tech Data’s Anti-Bribery and Anti-Corruption compliance program in the region, including delivery of training and implementation of enhanced compliance controls
- Works to enhance Tech Dat's reputation for doing business with integrity by maintaining appropriate visibility and participation in the region’s ethics and compliance community
- Perceived as highly competent with developed business acumen and good judgment
- Manages Nuveen open issues and management progress on action plans, appropriate escalation and reporting; and
- Moderate to advanced understanding of medical device and pharmaceutical compliance
4
Skills For Senior Director, Compliance Officer, EU / RoW Resume
- Able to initiate, embrace and support change in a dynamic environment
- Well-developed ability to influence without direct authority at multiple levels within area of responsibility
- Able to perform assignments involving responsibility for planning and conducting a complete project. Typically, has responsibility for the coordination of overall assignments
- Jazz Pharmaceuticals’ corporate compliance program
- Chair the EU/RoW Compliance Committee and ensure oversight of the implementation of Jazz’s compliance program within EU/RoW
5
Skills For Director, Frim Compliance Officer Resume
- Implement, under the supervision of the Chief Compliance Officer or his/her designee, ad hoc projects identified in the company’s annual compliance work plan
- Knowledge and understanding of healthcare compliance and the applicable legal and regulatory framework within the European Union and member jurisdictions, including the Foreign Corrupt Practices Act and the UK Bribery Act
- Experience communicating and working with government agencies and officials on EU compliance, legal or regulatory issues
- Understand corporate objectives and to work in partnership with business colleagues to implement effective compliance programs that are consistent with those objectives
- Demonstrated experience prioritizing conflicting demands from multiple business units in a fast-paced environment
- Outstanding interpersonal skills and proven ability to communicate and work with all levels of the organization (including regional management and field personnel)
- Excellent judgment and ability to quickly assess business challenges, and make independent and timely recommendations under pressure
- Strong intellectual capacity and ability to learn and comprehend complex business strategies as well as legal and regulatory environments
6
Skills For Health Care Compliance Officer, Director Resume
- Regular travel throughout the European Union and occasional travel to the United States is required
- Establish enterprise Volcker program standards, including standards ensuring that new businesses are onboarded as needed to the overall Volcker Compliance Program and legal entity listings used for Volcker Rule compliance and oversight are current, complete and accurate
- Collaborate with the Compliance Risk Assessment team to conduct the enterprise Volcker risk assessment
- Prepare and facilitate the annual CEO Volcker attestation process and monitor that the materials provided to the CEO for the annual attestation of the Volcker Program are accurate and timely
- Provide periodic reporting and metrics on Volcker compliance to senior management on not less than an annual basis, including the annual program update to the TIAA Board
- Collaborate closely with Business, Law, Finance, Risk, Compliance and Internal Audit partners on compliance related matters
7
Skills For Compliance Officer Director of Compliance Resume
- Support the Institutional Financial Services business Volcker Compliance program
- Ardent recognizes that each hospital is as unique as the community it serves
- E&CO is responsible to lead the implementation, development, and continuous improvement of an effective E&C Program at BI U.S. operating units or businesses focusing initially on the U.S. BI Animal Health business
- Closely business partner with senior leaders and in particular provide expert Ethics & Compliance advice to BI-AH Senior Leadership Team as well and other US BI OPU as needed/ as assigned
- Coordinate closely with the U.S. CECO to prioritize resources needed to manage an appropriate risk-profile and to support the overall US E&C program, especially related to Animal Health subject matter and other BI US OPU's as needed
8
Skills For VP Director Local Compliance Officer Resume
- E&CO is responsible for effective local E&C programs & budget, including without limitation, the seven Legal Compliance topics and implementation / maintenance of policies, procedures and training for all Compliance topics, and supporting the anti-bribery/anti-corruption (ABAC)vendor-screening and due diligence process
- At least six (6) to ten (10) years in Compliance, Legal or relevant business experience
- Focus on continuous learning
- Appropriately leverage available BI-USA & global E&C resources, BI-AH personnel and oversee external agents to achieve BI-USA and BI-AH Compliance objectives
- Demonstrated independence, strategic thinking and problem-solving to pro-actively assess evolving risk areas in US markets and manage an effective Compliance Program
- Comfortable and competent in operating in time-sensitive, high-risk and ambiguous situations, and influencing senior leaders to effectuate results within a margin of appropriate compliance risk
9
Skills For Director, Compliance Officer, AML / Sanctions Resume
- Demonstrates high ethical and professional standards at all times
- Without limitation, FCPA, Anti-kickback statute, the Ethics & Compliance Policy and Procedure, Code of Conduct, Speak Up Policy, Investigations Policy, ABAC and FMV program oversight, etc
- 1)Compliance Operations and/or Programs
- Facilitates and contributes to the development of the Annual Compliance Work Plan and related documents
- Develops and and leads ongoing compliance work plan reviews for purposes of identifying, assessing, and documenting potential compliance violations of the Standards of Conduct and policies and applicable local, state, and federal healthcare rules, regulations and administrative requirements; implements corrective action plans as required
10
Skills For Director, Compliance Officer, Anti-corruption Resume
- Reduces organization risk by identifying compliance risks and by developing and managing key work plan activities to address identified risks
- Creates and oversees a program to educate and communicate the importance of a strong culture of compliance to all Conifer leaders and team members – including the development and delivery of role-specific compliance training
- In collaboration with compliance and operational leadership, develops and/or oversees compliance policies and procedures
- Develops and implements key compliance monitoring activities; identifying, reporting, and implementing monitoring controls and making recommendations for training and/or other mechanisms to mitigate risks, or improve the efficiency or effectiveness of business operations and compliance program
- Provides ongoing compliance-related support to team members and key decision makers
- Partners and collaborates with leadership and business partners to communicate and integrate the compliance program throughout the organization
- Direct Reports:Compliance Officer, Manager, Specialist, Analyst, Sr. Specialist, and/or Sr. Analyst as applicable
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