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.
Monitor operational activities for compliance with healthcare policies and established procedures
Support compliance reviews of billing, coding, claims, and documentation processes
Assist with internal audits, compliance assessments, and corrective action plans
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company's size and culture are not specified in the posting.
Initiate and manage compliance onboarding for healthcare contractors, including credentialing verification.
Collaborate with staffing agencies and internal stakeholders to meet compliance deadlines.
Monitor credential expirations and maintain accurate records in the Vendor Management System.
Trio Workforce Solutions helps healthcare organizations manage workforce challenges through technology and services. The company is a mission-driven organization with a collaborative culture and growth opportunities nationwide.
Support the Chief Compliance Officer in developing and monitoring the Compliance Work Plan, including auditing and monitoring activities.
Manage intake, tracking, review, and response to governmental revenue cycle investigations and serve as the compliance resource for revenue cycle and operational leaders.
Develop and deliver role-based compliance training, translate regulatory changes into actionable policies, and monitor audit results to create corrective action plans.
UnityPoint Health is a healthcare organization providing comprehensive services across multiple states. Recognized as a Top 150 Place to Work in Healthcare, they are committed to team members and foster a culture of belonging.
Leverage state and federal Medicaid policy expertise to help agencies implement new programs and manage compliance.
Analyze regulations and sub-regulatory guidance to inform program direction and manage project initiatives.
Partner with the team to share Medicaid expertise and support client needs while driving team development.
BerryDunn is a professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies. Founded in 1974, the firm has a client-centered, people-first culture and has been recognized for its diversity and inclusion efforts.
Lead multi-state expansion and regulatory compliance for a health insurance carrier.
Own rate and form filings, licensing, and regulatory relations with state Departments of Insurance.
Build, implement, and maintain compliance policies, monitoring programs, and risk reporting.
Evry Health is a large group health insurance carrier focused on multi-state expansion and regulatory compliance. The company is a lean, fast-moving organization with a remote-first culture, seeking a foundational hire to build its compliance function.
Managing audit preparation, regulatory examinations, and due diligence requests.
Drafting policies and procedures and building a centralized governance framework.
Monitoring regulatory developments, conducting risk assessments, and developing board-level reporting.
LeafLink is the largest unified B2B cannabis platform, providing licensed businesses tools to manage operations, sell, and order from brands. With thousands of brands in North America, it processes $5B in annual orders and is a top workplace.
Develop, implement, and maintain compliance policies and procedures aligned with governmental requirements and contractual obligations.
Research compliance questions and regulatory issues, analyze impacts, and recommend corrective actions.
Prepare metrics, reports, and presentations for leadership to support compliance monitoring and business decisions.
Jobgether uses an AI-powered matching process to connect candidates with hiring companies. They are a recruitment platform that processes applications and shares top-fitting candidates directly with employers.
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.
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.
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.
Own and operationalize Avandra's compliance roadmap across HIPAA, HITRUST, and SOC 2, driving certifications and risk management.
Coordinate audit evidence, vendor security assessments, and customer due diligence while keeping audit-ready documentation.
Lead M&A compliance integration, including gap analyses and remediation plans for acquired entities.
Avandra Imaging is building the largest indexed data cloud of medical imaging to unlock clinical data for healthcare research. With over 5,000 customer integrations and roughly 70% market share, it is a growth-stage startup with a values-driven culture.
Ensure regulatory readiness, strengthen governance structures, and enhance reporting accuracy across the organization.
Oversee the policy management lifecycle, including creation, review, and approval, ensuring alignment with enterprise standards.
Manage lobbying reporting oversight and lead risk-based compliance reviews and training program lifecycles.
LISC is one of the country's largest community development organizations, helping forge vibrant, resilient communities across America. LISC works with residents and partners to close gaps in health, wealth, and opportunity so that people and places can thrive.
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.
Manage forensic review, investigative, and provider audit activities related to Medicaid medical, dental, behavioral health, pharmacy claims, as well as provider, member, financial, audit, TPL, and operational data.
Lead identification, documentation, and escalation of potential fraud, waste, abuse, or non-compliance risks, and review Medicaid claims for accuracy and compliance with policies.
Develop corrective action recommendations and follow-up plans to address identified fraud, waste, abuse, improper payment, compliance, claims, or operational issues.
BerryDunn is a client-centered, professional services firm that helps businesses, nonprofits, and government agencies solve challenges. The firm is led by CEO Sarah Belliveau, known for its inclusive workplace culture and focus on learning and well-being.
Monitor and research federal and state regulations, HRSA guidance, and manufacturer restrictions affecting 340B program compliance.
Translate regulatory changes into practical operational guidance for internal teams and covered entity clients.
Support audits, develop policy documentation, and deliver training on 340B program integrity requirements.
VytlOne provides pharmacy services and technology that fuel the entire pharmacy ecosystem, enabling pharmacy care. With nearly 100 years of pharmacy experience and 1,000 diverse employees, they offer the stability of a Fortune 500 company with the energy and innovation of a startup.
Develop and lead the enterprise compliance program strategy and roadmap.
Serve as program manager for compliance buildout and commercialization-readiness initiatives.
Provide practical guidance on healthcare compliance risks related to commercialization.
Kyverna Therapeutics is a patient-centered, clinical-stage biopharmaceutical company developing cell therapies for autoimmune diseases. The company is guided by core values and committed to transforming treatment for autoimmune disease, fostering a culture of ethics and integrity.
Lead complex Medicaid initiatives, including policy development, program implementation, and project management for state agencies.
Build relationships with clients, stakeholders, federal partners, and vendors while overseeing junior colleagues.
Deliver client deliverables such as policy recommendations, compliance analysis, and status reports.
BerryDunn is a professional services firm that helps businesses, nonprofits, and government agencies solve challenges through tax, advisory, and consulting services. Since 1974, the firm has been recognized for its diverse and inclusive culture, focus on learning and development, and employee well-being.
Influence entire compliance programs by translating strategic priorities into clear visions and executable programs with measurable outcomes.
Establish portfolio management frameworks and serve as the primary point of contact for executive leadership on mission-critical compliance programs.
Drive cross-functional delivery of regulatory compliance programs and improve audit processes for R&D.
Twilio is a leading communications platform that delivers innovative solutions to hundreds of thousands of businesses and empowers millions of developers worldwide. They are a remote-first company with a strong culture of connection and global inclusion.
Manage partner certifications and compliance across Microsoft, AWS, and Google Cloud programs.
Coordinate audits, evidence readiness, and certification tracking to maintain vendor designations.
Collaborate with practice leaders and cross-functional teams to align partner ecosystem strategies.
Myriad360 is a technology solutions provider that helps organizations implement and manage cloud and infrastructure solutions across leading platforms like Microsoft, AWS, and Google Cloud. The company is consistently recognized as a best place to work, fostering an inclusive, transparent culture with a strong focus on employee development and high-performing teams.