Manager, Compliance
Core
Manage compliance department functions including monitoring, auditing, and reporting to ensure adherence to federal, state, and local regulatory and contractual requirements for health plans.
Role type
Manager, Compliance
Builds
Compliance programs, corrective action plans, training materials, and regulatory reports
Domain
Healthcare administration and regulatory compliance
Required skills
Risk assessment, auditing, monitoring, reporting, corrective action planning, policy implementation, compliance training, licensure administration, RFP support
Preferred skills
Managed health and/or behavioral health experience
Technologies
N/A
Responsibilities
Manage approval and submission of contract and regulatory reports; oversee contract updates with Health Plans, States, and vendors; conduct periodic compliance assessments; implement corrective action plans; collaborate with Health Plans and States on customer satisfaction; manage submission of consumer and provider communication materials; handle state regulatory complaints and inquiries; determine and maintain licensure requirements; support RFPs and new business implementations; design and improve compliance processes; create and deliver annual compliance training.
Seniority
Manager, hands-on leadership
