CX Business Compliance Liaison

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist the Director of CX Business Compliance in converting approved requirements into uniform, evidence-based practices across Customer Experience accounts.

• Deliver daily compliance oversight, provide consultative guidance, coordinate escalations, generate reports, and offer implementation support for member and provider account access, provider EFT, and portal administrator modifications.

• Oversee verification-review activities conducted by Verification Specialists and Senior Verification Specialists.

• Track compliance with approved requirements, identify control deficiencies and recurring issues, offer compliance guidance, and escalate findings as necessary.

• Facilitate reviews of account work and independent quality reassessments.

• Assist in audit-the-auditor reviews, sampling, calibration, root-cause analysis, and validation of corrective actions.

• Monitor authentication, identity, and representative authority validation, trusted contact sources, outbound verification, approved scripts, and recording requirements.

• Act as an escalation contact for complex, disputed, incomplete, or high-risk cases, including potential fraud, privacy, or security issues.

• Collaborate with teams across Privacy, Security, Legal, Risk and Compliance, Operations, Quality, Technology, Training, implementation teams, and account leadership.

• Support quality monitoring and secret shopper initiatives, communicate findings, coordinate corrective actions, and track recurring issues until resolution.

• Draft and uphold policies, SOPs, scripts, checklists, and work aids.

• Organize role-based training, knowledge assessments, access requirements, refresher training, and production-readiness activities.

• Assist in new-account implementations by aligning procedures, controls, training, reporting, escalation pathways, and necessary approvals.

• Collect and validate compliance data, report trends, risks, corrective action statuses, and readiness gaps, while maintaining secure records and audit trails.

• Provide backup support to sustain CX Business Compliance activities and document actions and transitions.

⛳️ Requirements

• Bachelor's degree or an equivalent combination of education and relevant experience.

• A minimum of nine years of experience in healthcare operations, compliance, privacy, quality assurance, risk management, or a related discipline.

• Experience in a HIPAA-regulated environment with a focus on privacy, confidentiality, and information-handling requirements.

• Proficiency in reviewing business processes, documentation, or operational practices to detect compliance gaps.

• Experience in writing, developing, and maintaining policies, procedures, SOPs, or other controlled documentation.

• Skill in translating regulatory, contractual, or company requirements into actionable business processes and controls.

• Project management experience in coordinating initiatives, priorities, and issue resolution across various teams or business areas.

• Expertise in analyzing findings, recognizing trends or root causes, tracking corrective actions, and communicating risks and recommendations to business leaders.

• Proficient in Microsoft Excel, Word, PowerPoint, and SharePoint.

• Experience in Medicaid, healthcare compliance, privacy, provider operations, or member operations.

• Background in supporting compliance monitoring, quality reviews, audits, corrective-action programs, or process improvement initiatives across multiple accounts or business areas.

• Experience in supporting new implementations, operational readiness, policy or SOP governance, training, or leadership reporting.

• Familiarity with CXone, Motif, or similar case management, interaction review, verification, or reporting tools.

• Certification in compliance, privacy, security, or project management such as IAPP CIPP, CIPM, CIPT, PMP, CISA, CISM, or a comparable qualification.

🏝️ Benefits

• Work flexibility.

• Opportunities for learning and career development.

• Up to 10% travel opportunities.

• Flexible vacation policy.

• 401(k) employer match.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.