Revitalizing Compliance

At EmblemHealth, Debra Lightner is building cross-departmental relationships to bring compliance to the next level

When Debra Lightner was first contacted by a recruiter from EmblemHealth in 2016 about taking on a role as its senior vice president and chief compliance officer, she was immediately intrigued. Having spent the past two years as director of regulatory compliance for Horizon Blue Cross Blue Shield of New Jersey, after working for that organization for eleven years as in-house counsel, she was aware of how much her legal experience and business instincts could help revitalize a compliance department. “Lawyers learn to multitask and prioritize,” Lightner says. “Compliance requires the same agility: you have to be able to pivot and compartmentalize.”

During her two years with Horizon’s compliance department, Lightner strengthened its regulatory compliance program and instituted a robust communication plan with business stakeholders, fostering relationships and open dialogue throughout the organization. When she met with the new CEO of EmblemHealth, Karen Ignagni, who was focused on modernizing the nonprofit health plan’s business model and saw how passionate Ignagni was about supporting a strong compliance program, Lightner was hooked. “I knew the success that our business model achieved at Horizon,” Lightner says. “Karen’s level of support for compliance confirmed for me that the process would be successful at EmblemHealth as well.”

Debra Lightner, EmblemHealth

Quite similar to Horizon, EmblemHealth needed a fresh set of eyes to look at ways to build a new compliance strategy that aligned with the regulatory complexities of the industry and the company’s mission and goals. For Lightner, the two most important drivers of success are building relationships and fostering communication. She immediately set about doing both.

Her first step was to redesign the compliance department. Previously, all of Lightner’s team members had been trained to cover a broad range of compliance areas, rather than specialized fields. “What we needed were strong subject matter experts in compliance so that we could guide the business,” Lightner explains. She reorganized the department to create regulatory, corporate, privacy, and special investigations teams based on the strengths of each of her employees.

From there, she focused on building stakeholder relationships, sending teams out to partner with different areas of the business so that compliance could be involved in strategy development from the early stages. “When the compliance department has the reputation of being the bad cop, people will avoid it,” Lightner says. By making it clear to all areas of the business that her team was there to help them and mitigate the compliance risk hidden in any strategies they were developing, she was able to ensure that those strategies would have a clear path from the start.

Lightner’s next step was to make the compliance department visible throughout the company. Within the first month, she recorded a video, which was then posted on EmblemHealth’s internal network and broadcast in elevator reception areas to introduce herself and to highlight her department’s plans for the year. In early 2017, her team developed internal marketing materials that explained the department’s mission as well as the way that all employees play a role in the compliance program. The information was then distributed to every employee in the company.

One of the major victories in her first year was identifying new team members to help drive compliance, particularly in EmblemHealth’s product regulatory operations team. The team had previously reported to the sales and product development team. “They are regulatory subject matter experts with strong business stakeholder relationships. We need them driving regulatory compliance, monitoring performance, and contributing to strategy development,” Lightner says.

Within six months, the product regulatory operations team joined the regulatory compliance team, and the positive impact was immediate. “I can’t tell you how many business partners have come to me and said, ‘This is the greatest thing to ever happen in compliance at EmblemHealth. Now we have a centralized compliance function,’” Lightner says. Whereas business leaders had previously struggled to understand the uniqueness of the compliance department and the product regulatory operations team, her union of those resources now streamlined the relationship into a one-stop regulatory guidance shop.

Since then, Lightner has also seen other developments throughout the company as a result of her efforts, both in business partners reaching out cross-departmentally to engage with compliance and in increased collaboration. “Business teams and employees are coming to us to ask questions about how to be more compliant,” Lightner says, adding one of the main areas has been concerning privacy issues. “Compliance is at the table now, and we are consulted proactively as subject matter experts, which we hadn’t been before.”

One of the most personally satisfying results of her work, Lightner says, is seeing how much her team enjoys the work. It’s no coincidence that Lightner is committed to building morale and employee engagement. Having moved out of big law firm life and into an in-house counsel role, in part to have a more predictable schedule while raising her two daughters, Lightner has long been a strong proponent of work/life balance, and she’s ensured her team that she’ll be as flexible as she can as long as they’re getting their work done. “When you feel like senior leadership understands that you are a person with a life outside the office, it makes you want to bring the best version of yourself to the office,” Lightner says. “I’ve been fortunate to have that for most of my career, and I want to pass that on to my team.”

Some of her goals moving forward with EmblemHealth include increasing the effectiveness of delegate oversight and making sure that outside business partners are maintaining designated standards of compliance. She’s also focused on embedding her strategy deeper within the organization and its subsidiaries.

Now in her fourth year of working in compliance, Lightner says she hasn’t looked back once at her legal career, where she’d originally started out as a commercial litigator. “Compliance is different every day,” Lightner says. “I love that I continue to learn new things because that makes me want to come to work.”

Most importantly, though, she’s able to see how the results of her work are supporting EmblemHealth’s mission to modernize the business and bring better results to its members. “We’ve been able to put together teams, where people are able to use their best skills every day and bring their best selves to work,” Lightner says. “That, to me, is very rewarding.”

Photo: Michael Benabib

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