Director, Compliance at Wellframe

| Greater Boston Area
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At Wellframe, we reimagine healthcare relationships through a new approach that uses high-tech to deliver the high-touch support people need, when and where they need it. We call it Digital Health Management. Our comprehensive suite of Digital Health Management solutions for care management, advocacy, and navigation help organizations forge more meaningful connections with members, across their healthcare journey. 
Wellframe was founded to counter a pressing industry problem: the healthcare system has struggled to find ways to support people in between care settings, at scale. We believe health plans are in the best position to advocate for their members as they navigate their health and care, but know that technology alone can’t help us achieve this ambition. That’s why our team of physicians, clinicians, public health experts, data scientists, engineers, and healthcare industry experts ensure our patented technology works in service of the person-to-person connections that make healthcare work best.
Role Overview
Reporting directly to the Senior Corporate Counsel, the Senior Compliance Manager will be responsible for designing, coordinating, executing and overseeing Wellframe’s compliance program. As part of Wellframe’s Legal team, the Senior Compliance Manager will help interpret, communicate and implement compliance requirements and expectations throughout Wellframe and advise internal stakeholders on appropriate compliance risk mitigation strategies. This individual will serve as the subject matter expert on CMS compliance matters including answering questions from other teams within Wellframe and help deliver on compliance requirements for Wellframe’s customer base. In this role, this individual will be responsible for ongoing compliance with CMS and the various state regulatory requirements.
Areas of Responsibility:

Regulatory Compliance (40%)

  • Manage compliance policies; ensure policies are up to date through periodic review by subject matter experts; communicate policy changes as needed.
  • Stay current with CMS regulatory guidance and other relevant federal and state compliance laws and regulations and modify the compliance program accordingly to remain compliant, as well as consistent with industry best practices.
  • Advise on and negotiate CMS and other regulatory provisions in customer, vendor, and partner contracts

Corporate Compliance (30%)

  • Oversee all aspects of internal training for Wellframe, including, for example, new employee orientation, annual online training and department-specific training.
  • Manage enablement materials for cross-functional stakeholders on current and emerging compliance issues to influence how Wellframe thinks about relevant laws.
  • Document and review potential conflicts of interest.
  • Assist with maintenance of Wellframe’s Code of Conduct and Business Ethics and Employee Handbook.
  • Maintain records and documentation necessary to demonstrate compliance with applicable laws and regulations.
  • Assist with assessments assigned by customers and prospects.

Advisory (30%)

  • Evaluate new products and programs for potential compliance issues, and oversee remediation when issues arise; translate legal requirements into actionable advice for product and engineering teams.
  • Answer questions from internal departments about various topics and participate on teams that need to integrate or deliver compliance requirements.
  • Work across all departments to identify compliance risks, trends, vulnerabilities, and research solutions for risk mitigation.
  • Update senior management and department directors on changes in compliance requirements, expectations, and regulatory requirements.

Education, Experience, & Skills Required

  • Minimum of 7 years work experience in monitoring compliance with Medicare and Medicaid regulations, preferably within the health insurance industry.
  • Bachelor’s degree in health information management, business, healthcare, or related field; JD a plus but not required.
  • Certification in Healthcare Compliance required.
  • Experience with medical device regulation preferred.
  • Demonstrated ability to comprehend and interpret regulatory, legislative, and contractual mandates.
  • Broad-based in-depth knowledge of the managed care industry, including: strategic compliance planning, regulatory concerns, compliance requirements, and corporate integrity principles.
  • Record of collaboration and effective management of a compliance program.

Behaviors & Traits Required:

  • Excellent analytic skills and ability to effectively establish and achieve compliance requirements in collaboration with other teams.
  • Acts independently; determines methods and procedures on new, special or unique tasks or projects.
  • Strong written and verbal communication skills.
  • Comfortable with changing requirements and navigating ambiguity.
  • Generally adept at picking up new technologies.
  • Support Wellframe’s mission by exhibiting Tenacity, Humility, and Collaboration.

Wellframe, Inc. is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status or any other characteristic protected by local, state, or federal laws, rules, or regulations.
This posting is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee and any percentages listed are approximate. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

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Technology we use

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Location

Located in the Seaport, we are a short walk from South Station and surrounded by great lunch spots and coffee shops.

An Insider's view of Wellframe

What are some social events your company does?

Wellframe’s social events go beyond the regular happy hours (which we also do). Earlier this week, my team went bowling; with the Women of Wellframe group, we watched Ocean’s 8 together and have a potluck picnic coming up; and later this summer, we’ll all indulge in a beach day. It’s all made me feel a part of the company even as a new member.

Fabiola

Client Operations Associate

What's the biggest problem your team is solving?

Wellframe's engineering team is passionate about blending data, cutting edge technologies and security to build products that have a direct positive impact on patients' quality of life. To that end, we are currently designing the next generation of our architecture while expanding our infrastructure.

Mohammad

CTO

What is your vision for the company?

We see an opportunity over the coming years to work with more and more organizations that allow us to impact more patients more profoundly, and so we are investing a lot to not only grow commercially and bring on more clients and new partnerships, but to take on more ownership over helping our partners engage more with their patients or members.

Jake

President & CEO, Co-Founder

What makes someone successful on your team?

Tenacity: We go the extra mile to make our partners successful and inspire each other with our thirst for excellence.
Collaboration: We work constructively across disciplines to solve hard problems together.
Humility: We are never finished learning and growing, and we value the perspective and experiences of those around us.

Evan

Senior Director of People & Culture

What are Wellframe Perks + Benefits

Wellframe Benefits Overview

Wellframe recognizes that an employee benefits program is necessary for the health and well-being of our employees and their families. We are pleased to offer our employees one of the most competitive and comprehensive benefits packages in the industry.

Culture
Volunteer in local community
Wellframe participates in quarterly volunteer activities. In the past we've volunteered at More than Words, Community Servings, Boston Healthcare for the Homeless and West End Boys and Girls Club.
Partners with Nonprofits
Friends outside of work
Eat lunch together
Intracompany committees
Task forces across the company work on meeting culture, best way to streamline communications and Health Equity.
Daily stand up
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Unconscious bias training
Interview training is conducted at Wellframe 1-2 a year to minimize bias in the interview process.
Diversity Employee Resource Groups
Hiring Practices that Promote Diversity
Wellframe participates in diverse career fairs as well as provides anti-bias training for the company.
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Team workouts
Retirement & Stock Options Benefits
401(K)
Company Equity
Performance Bonus
Child Care & Parental Leave Benefits
Flexible Work Schedule
Remote Work Program
Family Medical Leave
Restricted work hours
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Company Outings
Stocked Kitchen
Some Meals Provided
Twice a week in-office lunches
Happy Hours
Recreational Clubs
Fitness Subsidies
Home Office Stipend for Remote Employees
Professional Development Benefits
Job Training & Conferences
Lunch and learns
Wellframe hosts Lunch and Learns once a month.
Cross functional training encouraged
Promote from within
Online course subscriptions available
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