Senior Compliance & QA Specialist
Core
Leads Spark's ongoing monitoring of downline agencies, managing risk-tiering methodology, corrective actions, and carrier-facing/executive reporting to ensure compliance with CMS Medicare regulations.
Role type
Senior Compliance & QA Specialist (Agency Monitoring)
Builds
Risk-based monitoring framework, carrier-facing compliance reports, executive dashboards, and Corrective Action Plans (CAPs) for downline agencies.
Domain
Healthcare (Medicare) + Regulatory Compliance
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
CMS Medicare regulations expertise, risk-tiering methodology design, root cause analysis, CAP/PIP development, data analysis, coaching/mentoring, Google Workspace proficiency
Preferred skills
Experience with compliance workflow/case management software, carrier partnership management
Technologies
Google Workspace, compliance workflow software, case management software
Responsibilities
Design and evolve risk-based monitoring framework for downline agencies; develop carrier-facing compliance reports; build executive-level dashboards; manage Corrective Action Plans and Performance Improvement Plans; conduct root cause analysis on compliance issues; mentor less experienced compliance specialists.
Seniority
Senior, hands-on IC with autonomy