Sr. Manager Corporate Compliance-Special Needs Plans
Core
Manage and execute Medicare and Medicaid compliance programs for Special Needs Plans (SNPs) to ensure regulatory adherence and mitigate compliance risks.
Role type
Senior Manager, Corporate Compliance (Healthcare)
Builds
Compliance strategies, risk assessment frameworks, and audit remediation plans for Medicare Advantage and Medicaid programs.
Domain
Healthcare / Medicare & Medicaid / Special Needs Plans
Deliverable
client delivery
Required skills
Medicare/Medicaid regulatory analysis, risk assessment, auditing, root cause analysis, corrective action oversight, project management, stakeholder influence, CMS contract interpretation
Preferred skills
Special Needs Plan (SNP) model expertise, external regulatory negotiation, complex matrixed environment navigation
Technologies
Archer, Microsoft products
Responsibilities
Serve as market compliance officer for assigned SNPs; track and interpret CMS/state regulations; lead compliance program implementation including risk assessment and auditing; manage external regulatory reviews and audits; develop compliance strategies to prevent and mitigate risks; facilitate communications with regulators; monitor corrective action implementation.
Seniority
Senior, hands-on IC with strategic oversight