Accomplished executive with a proven track record in operations leadership, regulatory compliance, risk management, and quality assurance. Extensive experience in building and transforming corporate compliance programs, utilizing background in regulatory compliance and auditing to effectively mitigate company risks. Strength lies in ability to collaborate with executive teams and stakeholders to drive meaningful change and foster a proactive culture of compliance and risk management. Talented leader consistently delivering strategic solutions that align with organizational goals. Demonstrated ability to develop strong partnerships instrumental in achieving success throughout career.
Hi, I’m
Kendall Marie Rice
Richmond,VA
Summary
Overview
21
years of professional experience
Work History
Elevance Health
Compliance Director
07.2023 - Current
Job overview
- Serve as a member on the Carelon Strategy Compliance Team, responsible for aligning reporting and compliance efforts across all Carelon subsidiaries and legal entities
- Provide compliance guidance and oversight for: annual compliance plans and addenda; compliance workplans; monthly reporting at the business unit/subsidiary level; compliance committee performance and content; regulatory audit activity, issue maintenance and regulatory integration; migration, integration and acquisition compliance; prepare reporting presentations, data, and analysis to Senior Leadership and other executive-level audiences
- Serve as compliance workstream lead for Elevance 30, an initiative to move 30 Case Management and Disease Management programs from Elevance Health to Carelon. Project includes heavy focus on regulatory requirement compliance and filings for all lines of business.
- Completed Carelon-Wide Maturity Assessment to measure compliance maturity in several key areas
- Provide best-practice guides for Compliance Committee presentations, Regulatory Integration Implementation, and Compliance Workplans
- Collaborate with Carelon Global Solutions on various compliance tasks and to align reporting efforts from an international perspective
- Assisted with creating mergers and acquisitions/ migration project management template for all compliance considerations
- Lead Carelon associate workgroups for Regulatory Integration – ensuring alignment with RI reporting, tracking, processing, and implementation efforts
- Liaise with legal, operations, and other departments for large, impactful regulations or mandates to drive efficiencies and alignment across Carelon
- Presentation materials creation for Town Halls, Audit Committee, Carelon Compliance Committee, and other various executive-level audiences
SOAR365
Assistant VP, Compliance, Case Management, & Quality
01.2016 - 01.2023
Job overview
- Manage compliance, case management, and quality assurance across all programs, including ID, DD, Federal, and Commercial Contracts
- Collaborate with team members and partners on risk and control initiatives
- Provide compliance and risk management guidance and consultation to lines of businesses on the requirements of applicable regulations
- Contribute to the development of business procedures and maintain a strong knowledge of business functions, processes, and practices
- Prepare for, coordinate, and respond to requests from internal and external audits and examinations
- Work with the team to manage and maintain internal tracking of new or changes in regulations
- Assist senior management in reporting and metrics relating to the risk environment
- Reduce cost, increase revenue, and address performance issues through data analysis, outcome reporting, and providing business solutions
- Spearhead initiatives for overall risk mitigation and metrics analysis by leading the Risk and Compliance Committee
- Oversee the department budget and prepare P&L statements for the Executive Team and Board of Directors, exceeding $18m annual revenue
- Comply with governing body regulations and accreditation surveys, including DMAS/CMS, DBHDS, DSS, CARF, ACA, DRPT, and HCBS
- Pivoted compliance initiatives during the rise of COVID-19 to create and implement company-wide protocols, policies, and contract tracing
- Designated as a member of the Corporate Leadership Team, leading to advancements in departmental efficiencies, including establishing annual revenue, departmental and company strategic goals, creating monthly and quarterly dashboard metrics and initiatives
The Pediatric Connection
Director of Nursing Operations
01.2014 - 01.2016
Job overview
- Planned, directed, and coordinated all operational activities while supervising 120+ Home Health Nurses and coordinating Private Duty Nursing Services for 60+ pediatric patients
- Oversaw and supported all business operations including human resources, staffing and scheduling reports, budgets, and development of policies and procedures
- Managed company-wide Joint Commission compliance to ensure Deemed Status for all three branches in DMEPOS and Home Health
- Developed and enforced policies and procedures that ensured quality patient care and operations
- Managed compliance with all regulations and guidelines as set by federal, state, local, and other agencies
- Facilitated positive and productive relationships with nursing staff through the recruiting, hiring, training, scheduling, and evaluation processes
- Completed regulatory audits across all departments to ensure policy and process compliance
- Wrote and edited company policies and processes based on JC/Medicaid guidelines
- Analyzed monthly and quarterly P&L statements and identified areas of improvement
- Increased departmental profitability and revenue by an average of 30% YoY revenue growth
- Enhanced strategies to increase profit margins, resulting in an 18% improvement from 2010-2016
- Boosted outreach efforts by creating community projects
- Designated as a member of the Corporate Leadership Team, leading to advancements in departmental efficiencies, including establishing annual revenue, departmental and company strategic goals, creating monthly and quarterly dashboard metrics and initiatives
NurseSpring/Nursefinders
Manager, Corporate Compliance & Training
01.2005 - 01.2009
Job overview
- Managed the hiring process for eight Nursefinders’ offices, including recruiting, hiring, training, and retention
- Conducted needs analyses and designed and implemented compliance training and development programs for all offices while serving as the corporate trainer for all new branches
- Participated in the development and implementation of training programs for all employees designed to promote knowledge of the corporate code of conduct policies, legal, and regulatory requirements of the business, in addition to trainings on payroll, compliance, and software
- Provided technical expertise, evaluated content, and made recommendations on incorporating all facets of corporate training programs into the business operation
- Negotiated contractual agreements; investigated all unemployment claims and workers’ compensation claims
- Instilled expectations for Branch Directors to meet or exceed weekly revenue goals of $200k
- Confirmed the compliance for 600+ field employees in eight offices by analyzing and auditing personnel files and preparing offices for corporate audits
- Heightened new client prospects by managing business development efforts for all offices
- Strengthened client retention by implementing performance metrics to ensure satisfaction
- Enhanced operational functionality and profitability for all field offices by offering solutions through observation
NurseSpring/Nursefinders
Branch Director
01.2005 - 01.2009
Job overview
- Directed all operational aspects from human resources and staffing requirements to administration and implementing policies
- Developed forecasts, branch goals, and strategic plans while also completing weekly invoices to all clients and preparing weekly payroll for 75+ field employees
- Met goals and metrics by providing training and development opportunities
- Located areas of improvement and proposed corrective actions to meet challenges and leverage growth opportunities
- Shared knowledge on effective practices, competitive intelligence, business opportunities and needs
- Advanced expectations of clients with exceptional customer service by recruiting top talent in healthcare
- Curated and upheld a complex and meticulously organized 18-hour daily schedule for 365 days a year including all major holidays for all team members
- Accelerated office sales to rank in Nursefinders’ “Top Ten” national rankings
March of Dimes
Community Director
01.2004 - 01.2005
Job overview
- Improved budgets and fundraising efforts by securing corporate sponsorships, led marketing initiatives by establishing cost-effective publicity, and increasing awareness to volunteer opportunities and events
Beyond Boundaries RVA
Board of Directors
01.2017 - Current
Job overview
- Serve to uphold the mission of offering individuals of all abilities the opportunity to experience outdoor activities in the community
Education
James Madison UniversityHarrisonburg, VA
Bachelor of Science
05-2004
University Overview
Virginia Commonwealth UniversityRichmond, VA
ACRE Certification for Employment Specialists
01-2022
University Overview
ECornell UniversityIthaca, NY
Certificate in HR Employment Law
11-2021
University Overview
ChamberRVA Leadership Lab Program
01-2013
University Overview
Skills
- Strategic Planning
- Risk Assessments & Mitigation
- Compliance Program Management
- Proactive Compliance Culture
- Operations Management
- Regulatory Compliance Requirements
- Risk Management
- Quality Assurance
- Process & Control Mapping
- Reporting & Auditing
- Compliance Training
- Procedures Development
- Change Management
- Continuous Quality Improvement
- Communication & Presentations
- Partnership Development
- Financial Management
- Regulatory expertise
- Team management
- Training delivery
- Ethical leadership
Timeline
Compliance Director
Elevance Health
07.2023 - Current
Board of Directors
Beyond Boundaries RVA
01.2017 - Current
Assistant VP, Compliance, Case Management, & Quality
SOAR365
01.2016 - 01.2023
Director of Nursing Operations
The Pediatric Connection
01.2014 - 01.2016
Manager, Corporate Compliance & Training
NurseSpring/Nursefinders
01.2005 - 01.2009
Branch Director
NurseSpring/Nursefinders
01.2005 - 01.2009
Community Director
March of Dimes
01.2004 - 01.2005
James Madison University
Bachelor of Science
Virginia Commonwealth University
ACRE Certification for Employment Specialists
ECornell University
Certificate in HR Employment Law
ChamberRVA Leadership Lab Program
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