Job Description
📋 Description Design, build, and own the operational compliance program structure Create scalable playbooks for high-risk areas (claims, eligibility, appeals) Lead and grow the operational compliance team and roles Define the compliance risk universe and prioritize resources Own hub-and-spoke model standards, reporting, and governance Translate ERISA, ACA, state DOI, CMS rules into operational requirements 🎯 Requirements Bachelor's degree in Healthcare Administration, Business, Law, Public Health, or related field 8+ years in health plan operations and/or health care compliance 5+ years leading compliance/operations/regulatory teams 5+ years building compliance programs 4+ years executive-level communication and guidance Deep knowledge of ERISA, ACA, state DOI, HIPAA 🎁 Benefits Alternative medicine coverage Flexible PTO Up to 16 weeks paid parental leave Paid holidays 401k program Education reimbursement
