In addition to legal knowledge, compliance work includes understanding the fields of business management, human resources, and risk management. A key compliance objective is understanding and anticipation of the potential downstream legal ramifications of each issue raised.
Compliance management ideally occurs before situations arise. Compliance represents the legal frontline for many organizations as conducting business in accordance with governmental and contractual obligations can stave off future courtrooms visits. Sound financial fundamentals supporting compliance activities and thereby avoiding unwanted litigation fees, fines, etc. when problems occur, can avoid needed investment just to keep the doors open.
Analysis of pertinent laws, rules, and regulations, certifications etc. e.g. ERISA, environmental, securities, privacy, HIPPA, Joint Commission on Hospital, etc., etc.
Application to business policies, processes, etc.
Implementation management/staff training
Compliance system tracking/maintenance
Administration of compliance-related change management activities
Administration/monitoring of claims and appeals review processes and procedures, customer services processes and procedures, legislative and regulatory developments, customer complaints, marketing and sales practices compliance, regulatory research and application to new and revised product and marketing, etc.
Coordination/communication with impacted business units
Development of reports to evaluate and analyze compliance
Performs analysis of business and compliance risk
Performs evaluations of business and compliance practices through industry benchmarking and/or "best practices" organization surveys/assessments
Project management of compliance projects of moderate scope and complexity and leadership of cross-functional
project teams, including directing assigned project team resources.