Compliance Officer

This is a fully remote position, open to applicants in New Hampshire.

📋 Description

• Provide strategic direction and oversight for the health plan compliance program, encompassing compliance governance, regulatory strategy, policy formulation, and cross-functional implementation.

• Ensure precise and timely execution of regulatory obligations across business and operational domains.

• Lead the design, implementation, and continuous effectiveness of the market compliance program in accordance with enterprise standards and regulatory requirements.

• Oversee compliance with CMS Medicare mandates, including SNP-related responsibilities, and guarantee timely submission of all necessary regulatory filings and documents.

• Act as the primary compliance leader and point of contact for state interactions, compliance meetings, and market-level escalations.

• Provide senior leadership during all Department of Insurance, Medicaid agency, and other regulatory audit processes relevant to the New Hampshire market.

• Collaborate with Corporate Enterprise Risk Management and market leaders to identify, evaluate, document, and mitigate compliance and business risks.

• Supervise internal compliance auditing and monitoring functions, direct corrective action planning, and hold business owners accountable for timely remediation and sustained compliance.

• Oversee the performance of delegated entities, vendors, and significant subcontractors, including annual oversight performance evaluation and corrective action follow-up.

• Chair or assist market compliance committees and provide regular updates to market and enterprise leadership regarding risks, trends, and remediation efforts.

• Lead, mentor, and develop compliance team members, establishing clear priorities, responsibilities, and performance expectations.

⛳️ Requirements

• Bachelor's Degree in a related field or equivalent experience is required.

• Master's Degree in a related field is preferred.

• Minimum of 7 years of experience in Compliance program management and contracts with State Medicaid programs, including internal and state audits, is required.

• At least 5 years of experience with health care regulatory agencies in developing compliance and fraud programs is necessary.

• A minimum of 5 years overseeing the implementation of contract requirements is required.

• Preferred experience includes over 10 years in Compliance/Enterprise Risk Management.

🏝️ Benefits

• Competitive pay

• Health insurance

• 401K and stock purchase plans

• Tuition reimbursement

• Paid time off plus holidays

• Flexible work arrangements, including remote, hybrid, field, or office schedules