Lead end-to-end investigations into compliance and ethics.
Translate complex regulations into practical guidance.
Identify systemic risks and ensure robust remediation.
Rula is dedicated to treating the whole person and aims to create a world where mental health is embraced as an integral part of one's overall well-being. They are a remote-first company that is dedicated to having a culture of inclusion that will support their employees.
Own and manage shared inboxes and ensure timely review, triage, escalation and routing of requests
Identify trends, risks, or recurring issues and ensure escalation and action planning
Conduct compliance audits, write corrective action plans and work with department managers to ensure timely completion and compliance with local, state and regulatory requirements
Centene is transforming the health of communities, one person at a time. As a diversified, national organization, they offer competitive benefits and a fresh perspective on workplace flexibility.
Responsible for ensuring that the Value Hub adheres to regulatory standards, contract requirements, and internal quality benchmarks.
Analyzing compliance data, preparing detailed reports, and working closely with various departments to maintain and improve compliance and quality standards.
Supporting the understanding of local regulatory requirements, completion of local audits, participation in quality committees, and supporting health plan needs and interactions to ensure consistent implementation of contractual obligations.
CommonSpirit Health has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside their hospitals and out in the community.
Responsible for planning and executing quality and oversight activities to ensure operational compliance.
Responsible for internal and external case audits for Capital and our delegated UM vendors.
Responsible for educating staff on findings, and the audit tool ensuring a consistent approach.
Capital Blue Cross promises to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”
Provide guidance for Affirm’s Product and Operations teams on applicable regulatory requirements related to any changes to products or services, issue remediation, and marketing reviews.
Review and approve financial services marketing materials to ensure they comply with regulations and industry standards.
Support responses to regulatory and bank-partner inquiries, audits, and examinations through second-line reviews and documentation/evidence.
Affirm is reinventing credit to make it more honest and friendly, giving consumers the flexibility to buy now and pay later without any hidden fees or compounding interest. The Legal, Compliance, and Public Affairs team is a group of dedicated professionals committed to helping Affirm scale, innovate, and provide outstanding products for consumers, merchants, and key partners.
Prepare regulatory filings, conduct routine audits, and organize documentation for legal reviews.
Collaborate with attorneys and business leaders to support compliance initiatives and respond to regulatory inquiries.
Provide guidance to internal stakeholders on compliance requirements.
AffirmedRx aims to improve healthcare outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. They are committed to making pharmacy benefits easy to understand, straightforward to access, and always in the best interest of employers. and the lives they impact.
Own and execute all CMS Section 111 (MSP) mandatory insurer reporting obligations.
Manage RxDC (Prescription Drug and Health Care Spending) reporting under the Consolidated Appropriations Act (CAA).
Serve as the internal SME on No Surprises Act (NSA) compliance, including Good Faith Estimate (GFE) requirements.
Centivo is an innovative health plan for self-funded employers with a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies and is headquartered in Buffalo, NY. They value being resilient, uncommon, and positive.
Supports compliance initiatives through data analysis and process improvement.
Develops and executes strategic business objectives supporting key business areas.
Develops training on compliance and privacy topics.
Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Their aim is to make personalized genetic testing and diagnostics part of the standard of care. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for their work and each other.
Monitor and interpret CMS, state Medicaid, and industry risk adjustment and quality regulations.
Provide SME guidance to Product, Sales, and Account Management on RA policy and program implications.
Partner with product teams to ensure solutions align with regulatory and audit requirements.
Cotiviti is a company that focuses on healthcare solutions. They offer a competitive benefits package to address a wide range of personal and family needs.
Conduct compliance risk assessments for products and operational changes.
Translate regulatory expectations into practical controls.
Design and implement scalable compliance controls.
EarnIn builds products that deliver real-time financial flexibility for those with the unique needs of living paycheck to paycheck. They are a fast-growing company with experienced leadership and world-class funding partners, aiming to bring world-class talent onboard.
Serves as the OFP’s principal advisor and center of expertise on federal and other government funding.
Offers enterprise-level insight on the federal landscape, regulatory changes, risk/benefit considerations, and strategic options.
Develops policies, procedures, training, and tools that strengthen readiness for government funding.
The American Heart Association is dedicated to fighting cardiovascular diseases and stroke. With over a century of trusted leadership, they drive breakthroughs in science, policy, and care for healthier people and communities.
Document and continuously improve legal and compliance processes, playbooks, and SOPs.
Support Machinify’s compliance programs in planning and executing projects and initiatives, and managing operational frameworks and workflows.
Research laws, regulations, contractual obligations, and internal requirements; synthesize findings into clear, actionable outputs.
Machinify is a leading healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. They have over 85 health plans deployed, including many of the top 20, and representing more than 270 million lives, and they are constantly reimagining what’s possible in healthcare.
Partner with product and marketing teams to ensure compliance with consumer protection regulations.
Monitor and analyze new and evolving regulatory requirements, assessing their impact on products.
Manage and develop a team of compliance professionals by setting clear expectations.
EarnIn is a pioneer of earned wage access, building products that deliver real-time financial flexibility for those with the unique needs of living paycheck to paycheck. It is a fast-growing company with experienced leadership and world-class funding partners.
Serve as a trusted guide for clients during onboarding, ensuring each group starts on time.
Answer questions and resolve issues across channels related to benefit administration and compliance.
Problem-solve with urgency when setup or configuration issues arise, ensuring programs start accurately.
Vitable is a health benefits platform that aims to make healthcare better for employers of everyday workers. They bring accessible, high-quality care to over 85 million uninsured and underinsured Americans and are growing rapidly, looking for eager team members who are hungry for change.
Maintain documentation for ISO/IEC 27001 & ISO/IEC 42001; improve activities.
Extract security requirements from client MSAs; identify gaps and risks.
Coordinate internal and client audit requests; collect evidence.
Avalere Health's mission is to ensure every patient is identified, treated, supported, and cared for. They bring Advisory, Medical, and Marketing teams together to forge unconventional connections, building a future where healthcare is not a barrier and no patient is left behind.
Supervise a team of appeals and grievances coordinators; develop/implement strategies to improve team performance and efficiency.
Receive, document, and manage member and provider appeals and grievances in accordance with Dignity Health MSOs policies and standards. Prepare and present reports on appeals and grievances activity.
Maintain detailed and accurate records of all appeals and grievances, including documentation of investigations, outcomes, and communications.
Dignity Health MSO offers management and business services that leverage economies of scale across provider types and geographies, leading the effort in developing Dignity Health’s Medicaid population health care management pathways. They focus on coordinating patient care while containing costs and improving quality of service. The company offers a Total Rewards package that integrates competitive pay with flexible Health & Welfare benefits and a generous employer-matched 401k retirement plan.
Design, manage, and execute the Compliance Assurance Plan.
Drive the evolution of our Compliance Independent Testing Team (CITT) through automation, data-driven monitoring, and modern control-testing practices.
Lead and develop a high‑performing team of Compliance Testers across United States and Costa Rica, responsible for conducting independent reviews, control testing, validation, and monitoring activities.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries and corporate headquarters are in Dublin, Ireland.
Review written communication for FINRA compliance and prevent non-compliant actions.
Review user transaction documents and support legal/compliance issues.
Assist in compliance Due Diligence and KYC/AML tasks.
Finalis is the leading platform enabling the securities brokerage landscape to operate legally and compliantly. Launched in 2020 and growing rapidly, the SF- and NYC-based firm is on a mission to power dealmakers by building the world’s largest dealmaking platform.
Under the direction of a senior member of the team, assume leadership and functional representation for projects of low complexity assigned ensuring effective and rapid coordination and management of deliverables striving the team to meet the agreed targets and to comply with the agreed procedures, trackers and templates.
Perform quality control of regulatory intelligence screening of legislative requirements updates and ensure maintenance of the regulatory intelligence database and timely dissemination of pertinent changes.
Provide internal teams and Clients with expertise and guidance on national requirements.
Ergomed Group is a rapidly expanding global full-service mid-sized CRO specializing in Oncology and Rare Disease. The company includes the more specialised brands- PrimeVigilance, Adamas Consulting and Ergomed CRO and values employee experience, well-being and mental health.
NASTAD is a leading non-partisan, non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. Their mission is to advance the health and dignity of people living with and impacted by HIV/AIDS, viral hepatitis, and intersecting epidemics.