Senior Compliance Analyst

This is a fully remote position, open to applicants in Arizona, +21 more states.

📋 Description

• Oversee the annual evaluation of the Compliance Program, Code of Conduct, and associated policies and procedures.

• Act as a senior subject matter expert in One Pass Compliance and take ownership of designated operational compliance functions.

• Provide guidance to business stakeholders and escalate compliance risks through appropriate channels.

• Administer the distribution of compliance training via the learning management system and ensure timely completions.

• Lead the intake, assessment, documentation, and resolution assistance for compliance hotline reports.

• Execute internal monitoring and quality assurance reviews of exclusions screening processes and controls.

• Prepare and conduct quality reviews of health plan client attestations and audits, including evidence collection and documentation.

• Evaluate conflicts of interest surveys and pinpoint issues that require follow-up actions.

• Collaborate in the development and implementation of the annual compliance workplan.

• Counsel Product, Technology, Security, and other cross-functional teams on compliance risks and strategies for mitigation.

• Deliver compliance responses to RFPs while ensuring confidentiality and adherence to compliance standards.

• Review marketing disclaimers and promotional materials for compliance with Medicare marketing regulations and HIPAA.

• Communicate compliance projects, risks, challenges, recommendations, and support requirements to the Compliance Lead and Chief Compliance Officer.

• Maintain the integrity of the Compliance Program and Code of Conduct.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Public Health, Business Administration, Compliance, or a relevant field.

• 5+ years of pertinent work experience in healthcare compliance, regulatory affairs, auditing, risk management, or a related healthcare operational role.

• Proven experience in supporting compliance programs, audit assistance, investigations, training administration, regulatory oversight, and cross-functional compliance initiatives.

• Strong organizational, analytical, written communication, and stakeholder management capabilities.

• Proficient in Microsoft Office applications, including Word, Excel, PowerPoint, SharePoint, and Teams.

• Certification in healthcare compliance or active pursuit of a healthcare compliance or auditing certification is preferred.

• Experience in supporting Medicare Advantage, managed care, or health plan compliance programs is preferred.

• Understanding of CMS requirements, HIPAA, delegated oversight, downstream entity monitoring, FDRs, FWA compliance, and regulatory audits is preferred.

• Experience in analyzing compliance and operational data for risk identification, risk reporting, dashboards, and compliance decision-making is preferred.

• Must reside in one of the eligible U.S. jurisdictions listed.

• Must be legally authorized to work in the United States.

🏝️ Benefits

• Flexible work environment

• Remote work supported across a number of U.S. states

• Equal employment opportunity and a work environment free of discrimination and harassment