Compliance Program Manager

Accountabilities:

Regulatory Monitoring and Analysis: Monitor, research, and interpret evolving federal and state healthcare laws, regulations, CMS guidance, and contractual obligations to identify new compliance requirements and emerging risks.
Business Impact Assessments: Evaluate the operational and organizational implications of regulatory changes, identify affected departments, and determine the actions necessary to achieve compliance.
Regulatory Change Management: Lead regulatory implementation initiatives from initial assessment through planning, execution, monitoring, and completion, ensuring requirements are addressed accurately and within established timelines.
Translation of Regulatory Requirements: Convert complex legal and regulatory language into clear, practical guidance, recommendations, and action plans that operational teams can implement effectively.
Cross-Functional Coordination: Partner with business leaders, operational teams, and other stakeholders to establish implementation plans, clarify responsibilities, resolve challenges, and maintain accountability.
Governance and Implementation Tracking: Facilitate meetings, committees, and governance discussions to monitor regulatory initiatives, evaluate organizational readiness, identify outstanding actions, and track progress against implementation milestones.
Reporting and Executive Communication: Prepare regulatory impact assessments, executive summaries, presentations, dashboards, and reports that communicate key findings, risks, recommendations, and implementation status to leadership.
Stakeholder Advisory Support: Serve as a trusted compliance resource for internal teams, answering questions about regulatory requirements and explaining their practical implications for business operations.
Risk Identification and Mitigation: Collect and synthesize information from business partners to identify implementation gaps, assess potential compliance risks, and recommend appropriate corrective or preventive actions.
Regulatory Inquiries and Special Projects: Support responses to regulatory inquiries and contribute to compliance-related projects, strategic initiatives, and operational improvement efforts.
Process Improvement: Identify opportunities to strengthen regulatory readiness, improve accountability, streamline implementation processes, and enhance the organization's overall compliance framework.
Compliance Culture: Promote proactive compliance practices through effective communication, collaborative problem-solving, stakeholder engagement, and continuous improvement.
Requirements:
Education: Bachelor's degree and relevant industry certifications, or an equivalent combination of education and professional experience.
Professional Experience: At least seven years of progressive experience in healthcare regulatory compliance, regulatory affairs, or regulatory change management.
Healthcare Industry Expertise: Direct experience in managed care, health plans, government-sponsored healthcare programs, or another highly regulated healthcare environment.
Regulatory Interpretation: Demonstrated experience interpreting and implementing new laws, regulations, CMS guidance, and contractual requirements, including the ability to assess their impact on business operations.
Healthcare Regulatory Knowledge: Strong understanding of Medicare, Medicaid, health insurance exchange markets, and/or commercial healthcare regulations.
Strategic and Analytical Thinking: Excellent analytical, critical-thinking, and problem-solving skills, with the ability to evaluate complex requirements, identify operational implications, and develop practical solutions.
Implementation Leadership: Proven ability to coordinate regulatory initiatives across multiple business functions, establish implementation plans, monitor progress, and drive projects through completion.
Communication Skills: Exceptional written and verbal communication skills, including the ability to explain complex regulatory concepts to diverse audiences and prepare clear, executive-level presentations.
Stakeholder Management: Strong interpersonal skills and the ability to build relationships, facilitate discussions, influence stakeholders without direct authority, and encourage accountability across teams.
Project and Priority Management: Ability to manage multiple initiatives simultaneously, prioritize competing deadlines, navigate ambiguity, and maintain attention to detail in a fast-paced environment.
Technical Proficiency: Advanced proficiency in Microsoft Office applications, particularly Excel, Word, PowerPoint, and SharePoint.
Preferred Regulatory Change Experience: Previous experience leading regulatory change management programs or coordinating enterprise-wide regulatory implementation initiatives.
Preferred Operational Knowledge: Familiarity with healthcare operations, including utilization management, provider operations, claims administration, or related health plan functions.
Advanced Analytical Tools: Experience using advanced Excel capabilities, including pivot tables, charts, conditional formatting, and data analysis tools.
Governance and Facilitation: Experience facilitating committees, governance groups, or cross-functional implementation teams is an advantage.
Professional Attributes: A proactive, curious, and adaptable mindset, sound judgment, strong attention to detail, and a commitment to translating regulatory complexity into effective business outcomes.
Work Authorization: Candidates must be based in the United States. Employment sponsorship and relocation assistance are not available.
Benefits:
Competitive Salary: Annual base salary range of $105,000–$115,000, depending on geographic location, skills, education, experience, and internal pay equity considerations.
Retirement Benefits: A 401(k) retirement plan with employer matching, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice.
Comprehensive Healthcare: Medical insurance with low-cost employee-only premiums and employer subsidies for eligible dependents.
Dental Coverage: 100% employer-paid dental insurance for employees and eligible dependents.
Vision Insurance: Vision coverage with low-cost premiums for employees and eligible dependents.
Life and Disability Insurance: Employer-paid basic life and accidental death and dismemberment (AD&D) coverage equal to one times base salary, optional supplemental coverage, and long-term disability insurance.
Flexible Spending Accounts: Options for healthcare and dependent care expenses.
Additional Insurance Options: Voluntary accident, critical illness, and hospital indemnity insurance programs.
Paid Time Off: Generous vacation and sick leave policies, including the ability to roll over unused time.
Paid Holidays: Ten company-paid holidays annually.
Wellness Programs: Access to company-wide wellness challenges, BurnAlong memberships, gym discounts, and other health and wellness resources.
Employee Assistance Program: Resources to support mental health, personal well-being, and work-life balance.
Education Assistance: Tuition reimbursement for eligible educational expenses and opportunities for continued professional development.
Flexible Work Arrangements: Remote or hybrid work options may be available, depending on the position's requirements.
Inclusive Work Environment: A workplace that values diverse perspectives, equal opportunity, collaboration, and professional growth.
Meaningful Professional Impact: The opportunity to influence regulatory strategy, improve organizational readiness, and support compliant healthcare operations.