Lead portions of regulatory assessments, external audits, and accreditation processes for Commercial, Medicare, Medicaid, and Marketplace departments.
Act as primary point of contact for internal and external partners on regulatory activity, quality efforts, SOP development, and client delegation agreements.
Maintain regulatory gap status reporting, track work streams, and lead change management related to regulatory requirements.
Prime Therapeutics is a pharmacy benefit manager (PBM) with a purpose beyond profits, reimagining pharmacy solutions to connect care for those they serve. The company is a large, purpose-driven organization focused on simplifying healthcare and fostering a collaborative culture.
Lead the development and improvement of product compliance programs, including policies, procedures, and monitoring frameworks.
Apply regulatory judgment to complex compliance issues, conduct risk assessments, and support corrective actions.
Leverage AI-enabled tools to enhance compliance documentation and analysis, while collaborating with cross-functional teams.
The company provides an AI-powered job matching platform for candidates and employers. It is a partner-driven organization that focuses on compliance solutions in healthcare, with a small to medium size, offering remote work flexibility and a culture of continuous improvement.
Manage regulatory inquiries of PLICO and affiliated insurance companies.
Respond to inquiries from regulatory bodies for insurance and securities activities.
Partner with business and divisional compliance units to coordinate regulatory filings.
Protective helps protect customers against life's uncertainties. The company is a large insurance provider with a strong focus on employee well-being and a collaborative culture.
Evaluate Medicare regulatory requirements and CMS guidance to assess compliance risks for government contracts.
Serve as a subject matter expert to ensure regulatory requirements are implemented accurately and timely across operations and partners.
Collaborate with stakeholders to develop and monitor mitigation strategies for compliance risks and issues.
HCSC expands access to high-quality, cost-effective health care and equips members with tools for better decisions. As an industry leader, they have over 80 years of experience and offer compelling careers in a collaborative, innovative environment.
Draft policy forms reflecting underwriting intent and regulatory requirements for assigned lines of business.
Manage complex product projects collaborating with Underwriting, Claims, Legal, and Actuarial to produce final insurance products.
Review and assess regulatory changes to determine filing and regulatory requirements, and independently review advertising materials for compliance.
Crum & Forster provides market leading property & casualty, accident & health, specialty and standard commercial lines insurance solutions. With 3000 employees and locations throughout the US and India, the company is consistently recognized as a great place to work, earning multiple workplace and wellness awards.
Lead advanced Product Compliance activities to ensure administrative solutions align with laws and regulations.
Apply expert regulatory judgment to complex compliance inquiries and escalations using AI-enabled tools.
Partner with stakeholders to incorporate compliance requirements into strategic initiatives and operational changes.
HealthEquity is dedicated to saving and improving lives by empowering healthcare consumers through health savings accounts and related solutions. The company is a mid-to-large size organization that fosters a culture of inclusion, innovation, and continuous learning.
Serve as a trusted compliance advisor across benefit products, ensuring regulatory alignment while supporting innovation and operational excellence.
Review marketing materials, customer communications, and product documentation to ensure regulatory accuracy and consumer protection compliance.
Lead compliance risk assessments for new product features, workflow changes, and emerging technologies, including AI-powered solutions.
They provide innovative healthcare benefit products and financial wellness solutions. The company offers a collaborative, fast-paced environment with a focus on regulatory excellence.
Ensure compliance with regulations and funding requirements across grants and contracts.
Oversee contract lifecycle, reporting, and audits for private, state, county, and federal contracts.
Lead compliance trainings and supervise team members to maintain organizational standards.
The YMCA is a nonprofit organization focused on social services and community development. With a significant presence in San Diego County, it emphasizes compliance, collaboration, and team-oriented culture.
Develop, implement, and improve HSE programs to support regulatory compliance, risk reduction, and operational excellence across multiple client sites.
Train facility employees on HSE policies, monitor compliance, and conduct incident investigations to drive corrective actions.
Analyze HSE data and trends to identify preventive measures, and coordinate with stakeholders to promote a strong safety culture.
Our partner is looking for a Health Safety and Environmental Specialist based in the United States. This remote role is responsible for strengthening health, safety, and environmental performance across multiple client sites, with a focus on compliance and continuous improvement.
Lead compliance functions for self-funded health plans, ensuring regulatory adherence across plan administration, filings, and vendor relationships.
Manage regulatory filings including SPDs, Form 5500, and PCORI fees, and act as primary compliance liaison with TPAs, PBMs, and carriers.
Develop and maintain internal compliance policies, provide training, and serve as HIPAA Privacy and Security Officer.
Vitable is a health benefits platform designed for every worker, making it easy for employers to offer high-quality healthcare to their teams. They are a small, passionate team moving fast and solving a problem that genuinely deserves solving.
Ensure compliance and program requirements for a specialized K-12 educational program in Indiana.
Serve as the subject matter expert, translating complex requirements into actionable guidance for teachers and staff.
Monitor program fidelity through data, audits, and risk identification, driving continuous improvements.
OpenEd is a technology company dedicated to providing customized, world-class education to every learner, serving over 100,000 students and growing rapidly. Their culture, with an eNPS of 76, emphasizes values like customer obsession, action, and feedback, fostering a supportive and collaborative environment.
Monitor and interpret benefits compliance requirements across countries, ensuring statutory and supplemental benefits align with regulations.
Conduct audits of benefits processes, data, and vendor outputs to identify and remediate compliance risks.
Partner with Legal, Payroll, Finance, and Product teams to design and implement compliant benefits controls and documentation.
Remote is a global employment platform that helps businesses of all sizes recruit, pay, and manage international teams. With a fully remote and async culture, the company has employees across six continents and is committed to innovation and diversity.
Investigate complex credit reporting disputes and SCRA determinations, bringing stakeholders together for broader input.
Translate new state legislation into actionable compliance guidance and lead quarterly monitoring and testing.
Serve as subject matter expert on consumer protection laws, shaping policies and controls as the company scales.
Reprise Financial simplifies personal loans, making them accessible and transparent with loans up to $25,000. The company values innovation and collaboration, providing tools and support for employees in a customer-focused environment.
Serve as the go-to compliance resource for HSA, FSA, and HRA products, ensuring compliance with regulatory requirements.
Lead compliance risk assessments for new product features and platform developments, including AI-powered tools.
Monitor regulatory developments and produce actionable impact assessments for affected teams.
Lively set out to raise the bar on benefit solutions, offering a modern HSA and a full suite of benefits. It is a remote-first company with employees across the US, focused on user-centric design and innovation.
Evaluate mortgage and protection journeys to ensure compliance with regulations.
Provide technical compliance advice to mortgage and protection teams.
Conduct root cause analysis of compliance issues and support risk assessments.
Habito by Monzo uses technology and expert mortgage advisers to simplify the mortgage process. They are a forward-thinking company focused on innovation, with a diverse and inclusive team.
Manage client medical payment policies to ensure accuracy and compliance with CMS and payer guidelines.
Conduct periodic reviews and analyses of policy updates, coordinating with Medical Directors and presenting recommendations to clients.
Serve as the primary client liaison, addressing inquiries and maintaining detailed documentation of policy nuances.
Cotiviti is a healthcare data analytics company specializing in payment accuracy and medical policy management. The company fosters a collaborative remote culture and offers competitive benefits to support its team.
Lead multiple professional teams in fiduciary administration services, ensuring high-quality service and operational excellence.
Manage team performance, develop future leaders, and drive progress toward organizational goals through strategic planning.
Oversee regulatory compliance, process improvement, and client retention initiatives while staying informed on industry trends.
Jobgether uses AI-powered matching to connect candidates with hiring companies. It is a platform that processes applications and shares top candidates with employers, operating remotely.
Manage day-to-day operations of the compliance program, ensuring adherence to healthcare regulations including HIPAA and state/federal laws.
Conduct thorough compliance investigations and develop key risk indicators and monitoring programs to evaluate risk mitigation strategies.
Design and deliver engaging compliance training for patient-facing teams, translating complex regulations into practical workflows.
Equip is the leading virtual, evidence-based eating disorder treatment program on a mission to ensure that everyone with an eating disorder can access treatment that works. Founded in 2019, Equip has been a fully virtual company since its inception and is proud of the highly-engaged, passionate, and diverse Equipsters that have created Equip’s culture.
Manage governance forums, agendas, decision logs, and action tracking.
Support execution of strategic compliance priorities and monitor cross-functional dependencies.
Coordinate departmental KPIs and executive dashboarding.
HealthEdge is a healthcare technology company that provides software solutions for health plans and payers. The company fosters a culture of accountability, transparency, and compliance, operating remotely across the US.