Valenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity, and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan, and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality, and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare.
About Our Opportunity:
As our Compliance Manager, you’ll have responsibility for our compliance and privacy initiatives, ensuring alignment with regulatory standards and best practices. This includes compliance and privacy policy coordination and development, coordinating and performing all annual and due diligence audits, ensuring compliance with the Utilization Review Accreditation Commission (URAC), the National Committee for Quality Assurance (NCQA), and federal, state and contractual requirements.
Things You’ll Do Here
:
Policy Development and Coordination:
- Develop and maintain corporate compliance and privacy policies, processes, and procedures.
- Confer with and advise other internal Valenz entities to create and maintain compliant operational processes and procedures.
Audit Management:
- Perform audits related to compliance and privacy, including release of information, business associate and vendor agreements, sanction screenings, and remote worker privacy surveys.
- Prepare analysis and reports of findings, including recommended corrective action items.
- Perform follow-up reviews of previous findings to ensure corrective action items have addressed noted compliance issues in a timely manner.
Regulatory Compliance:
- Coordinate URAC and NCQA reaccreditation processes by ensuring all activities, documents, and evidence are prepared, maintained, and trained as required.
- Assist internal stakeholders in obtaining and maintaining HITRUST certification.
- Implement and execute compliance monitoring functions based on risk assessments and prioritization, with a focus on annual regulatory risk assessments.
- Participate in the quarterly review of compliance risks and development of quarterly work and audit plans.
- Maintain compliance monitoring functions based on risk assessments and prioritization.
Incident Management:
- Assist with conducting and managing compliance and privacy-related incidents, partnering with stakeholders to identify, document, and mitigate privacy and/or compliance risks.
- Escalate reportable data breaches to the Chief Compliance Officer and assist as needed.
- Manage, track, and triage reported compliance matters, including assisting with handling ethics hotline, compliance mailboxes, or other items.
Reporting and Communication:
- Report quarterly to the Corporate Compliance Committee on the status of the Compliance Program.
Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.
What You’ll Bring to the Team
:
- Bachelor's degree in a related field (e.g., Business, Law, IT, etc.).
- 7+ years of experience in compliance, auditing, or a related field within the healthcare or insurance industries developing policies and procedures, performing internal compliance audits, and working with internal and external partners on compliance requirements
- Strong analytical and problem-solving skills, excellent communication and interpersonal skills, and proficiency in compliance and audit best practices.
- In-depth knowledge of regulatory compliance requirements, especially related to Utilization Management, ERISA, HIPAA, and the ACA.
- Familiarity with federal and state privacy regulations and data protection laws.
A plus if you have:
- A master’s degree or relevant certifications (e.g., CCEP, CHC, CISA) is preferred.
- Experience in the health plan/employer group self-insured space.
Experience building formal healthcare regulatory compliance programs.
Where You’ll Work
This is a fully remote role!
Why You Will Love Working Here
We offer employee perks that go beyond standard benefits and compensation packages – see below!At Valenz, our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. We want everyone engaged within our ecosystem to be
strong, vigorous, and healthy. You’ll find limitless growth opportunities as we grow together. If you're ready to utilize your skills and passion to make a significant impact in the healthcare self-funded space, Valenz might be the perfect place for you!
Perks and Benefits
- Generously subsidized company-sponsored Medical, Dental, and Vision insurance.
- Spending account options: HSA, FSA, and DCFSA
- 401K with company match and immediate vesting.
- Flexible working environment.
- Generous Paid Time Off to include Vacation, Sick, and Paid Holidays.
- Paid maternity and paternity leave.
- Community giveback opportunities, including paid time off for philanthropic endeavors.
At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.
We will not tolerate discrimination or harassment based on any of these characteristics.
