Progyny is seeking an experienced Senior Director of Healthcare Compliance to oversee and manage our complex healthcare regulatory and compliance needs as our company continues to grow. This role will determine applicability of and ensure compliance with state and federal healthcare regulations, including licensure and associated regulatory reporting requirements across multiple jurisdictions. A key requirement for this role is to develop and maintain strong relationships with key regulatory bodies. The Senior Director will provide leadership to ensure our compliance program meets the highest standards.
What you’ll do…
- Work with the Group Vice President, Regulatory Compliance and compliance team members to develop, implement, and oversee the healthcare compliance program to ensure adherence to state and federal regulations and state licensing requirements.
- Manage and maintain all healthcare related licenses (UM/UR, TPA, PBM, fully insured, others as needed), ensuring timely renewals and compliance with associated reporting requirements in each applicable state.
- Provide strategic guidance to leadership on evolving regulatory changes and their impact and required actions.
- Build and maintain strong relationships with regulators, acting as the primary point of contact for compliance-related matters.
- Lead company responses to regulatory audits, data requests, and market conduct exams, ensuring timely preparation and resolution of any findings.
- Collaborate with internal departments, including legal, operations, network, and product teams, to ensure alignment with compliance requirements and corporate goals.
- Provide leadership and mentorship to direct reports, fostering professional growth and ensuring the team’s effectiveness.
- Create and maintain policies, procedures, and training programs to ensure company-wide compliance awareness.
- Partner with leadership to establish proactive strategies for managing compliance needs and driving operational excellence.
About you…
- Minimum of 8-10 years of experience in compliance or regulatory affairs within the insurance or healthcare industries, with expertise in state-specific regulations.
- Strong understanding of licensing processes and regulatory requirements for health insurance providers and/or pharmacy benefit managers.
- Proven track record of building and managing relationships with regulatory agencies and navigating complex regulatory environments.
- Experience managing and mentoring teams, with strong leadership and decision-making skills.
- Exceptional organizational, analytical, and problem-solving abilities, with a detail-oriented approach to compliance management.
- Excellent verbal and written communication skills, with the ability to convey complex regulatory concepts clearly to diverse stakeholders.
- Bachelor’s degree in Business Administration, Healthcare Administration, or a related field; advanced degree (e.g., JD, MBA, or MPH) preferred.
- Hybrid work schedule: candidates must be available to work onsite Tuesday through Thursday each week.
Application process…
If you are a compliance leader with a passion for navigating complex regulatory landscapes and contributing to meaningful change in healthcare, we encourage you to apply.
