Employment Type : Full-Time
Organizational Overview As an Associate with SS&C Health, you will be part of an organization that promotes better health outcomes for consumers through clinical and technological innovations. We accomplish this by leveraging the robust technology foundation and powerful analytic resources that are the core of SS&C, with industry leading clinical expertise and strategic pharmacy and healthcare solutions. You will join a team that is redefining the value of pharmacy in healthcare through the integration of advanced analytics, clinical insights and transformative digital capabilities. Role Overview The essential functions of the position include administering internal compliance programs that span the organization, ensuring oversight and monitoring programs are in place for subcontractors and related entities, and promoting a compliance culture throughout the organization. The Director of Risk Management will develop, implement, coordinate, and manage internal compliance programs across the organization to ensure compliance with all federal and state laws and regulations pertaining to SS&C Health as a provider of services to the healthcare industry. This role will work closely with executive leaders, internal department managers, and as applicable, DST Systems and DST Healthcare resources to strengthen a culture of personal accountability with regard to compliance throughout the organization; evaluate the adequacy and effectiveness of internal controls designed to ensure that processes lead to appropriate execution of regulatory requirements and guidelines; ensure effective processes are in place to promptly identify and disclose high-risk issues and execute internal and external corrective action plans; and recommend revisions to the company’s compliance program structure, internal compliance programs, and compliance policies & procedures, as appropriate, to respond to changing industry, legal and regulatory requirements or identified compliance program weaknesses. In concert with the Chief Compliance Officer will be responsible for ongoing development of a proactive risk management program to help mitigate and prevent risks. Individual candidate should work with operational resources to identify and evaluate risks in a health care claims processing and data analytics environment, which should reduce access to care issues for Customer membership. Responsibilities • Directs staff and initiatives that support risk management programs, to include governance support, risk oversight, risk infrastructure development, identification, quantification, and aggregation of key and emerging risks and/or operational risks and controls. • Regularly leads and conducts complex and varied analyses of issues or concepts with broad impact. Uses data to evaluate the organizations' compliance with risk management goals. • Partners with key stakeholders in the business and oversees the identification, assessment and documentation of risks and controls, including risks associated with new or modified products, services, distribution channels, regulations and/or third-party operations. • Instrumental in the effort to develop risk management annual plans. Makes recommendations for department goals and long-term strategy. • Formulates risk management policies, procedures and standards in conjunction with senior management and risk management committees; implements said policies and ensures ongoing compliance with these policies. • Monitors and develops the Risk Profile Report to ensure the metrics and attendant thresholds/limits are reflective of the external/internal environment and the enterprise's risk appetite. • Ensure policies and processes reflect new developments, updated regulatory requirements, and best practice methodologies. Regularly leads and guides upper management on risk management matters, impacting the entire organization. Informs compliance leadership on a regular basis about areas of risk exposure and plans to address those exposures. • Identifies areas for improvement and develops methods for assessing internal and external compliance, risk and increased efficiency. • Conducts and analyzes reports related to special risk management investigations. Monitors claims and incidents for early intervention opportunities to mitigate exposure and prevent further events. • Participates in developing and presenting in-service training programs for staff on risk management principles. • Other duties as assigned. Qualifications Bachelor’s degree and 8 years of work-related experience, or Master’s degree and 6 years of work-related experience, or 10 years equivalent work-related experience Broad healthcare industry knowledge that focuses on current practices and trends, including government regulation. Experience with Medicare/Medicaid compliance or operations is required Specific experience in risk management programs in a healthcare environment. Excellent organization and project management skills. Proven experience developing plans for and managing the successful execution of high-visibility initiatives. Ability to work effectively with people at all levels of an organization; experience partnering with cross functional teams to accomplish common goals. Understanding of business issues as well as regulatory requirements. Inquisitive and analytical problem solver with initiative and ability to work independently Ability to think both strategically and tactically, and develop and manage high-level plans and strategies. Excellent verbal and written communication skills. Ability to read, analyze and interpret governmental regulations and legal documents. Demonstrated ability to mentor and develop team members. Demonstrated ability to effectively utilize PC software (e.g. Microsoft Office) Characteristics of being energetic, self-starter who is resourceful and creative. Location: SS&C is an equal opportunity employer and values a diverse and inclusive workplace. All qualified candidates will receive consideration for employment without regard to age, race, color, religion, genetic information, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. For more information about Equal Opportunity in the Workplace please click here and here . SS&C is committed to working with and providing reasonable accommodation to job applicants with disabilities. If you are a qualified individual with a disability and need an accommodation or accessibility assistance to complete the online application, please contact us at PeopleCenter@dstsystems.com for assistance.