Senior Compliance Program Manager

Collective Health

Collective Health

Legal, Operations
Posted on Saturday, October 14, 2023

We all depend on healthcare throughout our lifetimes, for ourselves, and our families and friends, but it is notoriously difficult to navigate and understand. As an industry that comprises 20% of the US economy we think healthcare should work better for all of us. At Collective Health we believe it’s time for a new day in healthcare where as members we are informed and empowered to make the right care choices when the decisions are urgent and critical.

The Senior Compliance Program Manager is responsible for day-to-day programmatic operations of Collective Health’s Compliance Program with a focus on compliance matters that arise for a Third-Party Administrator (TPA) responsible for claims administration for ERISA (Employee Retirement Income Security Act) plans. Reporting to the Compliance Officer, this role will be responsible for supporting the organization’s mission to ensure compliance with all relevant laws, regulations, and industry standards related to healthcare and benefits administration.

What you'll do:

  • Manage day-to-day operations of the Compliance Program in coordination with the Compliance Officer.
  • Lead Compliance Program initiatives to ensure that business operations of Collective Health are supported and comply with state and federal laws related to general compliance, claims administration, and ERISA.
  • Ensure all Compliance Program projects are completed (or repeated) in a timely manner, to a professional quality level, and communicated appropriately to the appropriate teams and leaders across Collective Health.
  • Responsible for reviewing and drafting necessary compliance policies in conjunction with stakeholders, and other documents needed to align with regulatory requirements, industry benchmarks, and programmatic functions.
  • Responsible for assisting the Compliance Officer with creation and implementation of the Annual Risk Assessment and Compliance Work Plan.
  • Responsible for overall development and maintenance of the Compliance Training program.
  • Manage the Compliance Hotline including investigation, remediation and corrective action as needed.
  • Provide timely and accurate guidance to all departments on compliance matters to ensure compliance with applicable regulations and standards.
  • Support response to external audits and activities for Collective Health.
  • Manage and oversee the enterprise conflicts of interest policy and process.
  • Participate in workgroups and provide advice related to compliance with applicable compliance requirements.
  • Conduct research and provide recommendations to business leaders related to compliance matters.
  • Assist with review of and response to external and internal audits and/or investigations involving regulatory and compliance matters.
  • Support the Chief Compliance Officer in preparing reports and updates for the Board of Directors and management team on compliance matters.

To be successful in this role, you'll need:

  • Bachelor's degree in a related field or other relevant professional experience; Masters or Juris Doctorate strongly preferred.
  • 5-10 years experience working in healthcare or in advising healthcare entities; payor, TPA and/or ERISA-experience preferred.
  • Health plan compliance/regulatory experience strongly preferred.
  • Significant knowledge of compliance regulations impacting healthcare entities.
  • Significant experience creating and managing compliance programs.
  • Experience creating and managing Compliance Risk Assessments and Compliance Work Plans.
  • Excels in a fast-paced, complex environment where business initiatives and priorities are constantly evolving.
  • Proven ability to build relationships and collaborate with a broad range of stakeholders, team members, and departments.
  • Outstanding judgment and organizational skills.
  • Excellent communication and presentation skills in explaining the how and why behind compliance programs to stakeholders.
  • CHC certified or CHC eligible.

Pay Transparency Statement

This job can be performed from our Lehi, UT, or Plano, TX, office, or hired for remote work in the following states: CA, CO, CT, FL, GA, IL, MA, MI, MN, NJ, NY, NC, OH, OR, TX, UT, or WA. #LI-remote

The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/#benefits.

Chicago, IL Pay Range
$140,000$175,000 USD
Lehi, UT Pay Range
$121,200$151,500 USD
Remote Pay Range
$108,400$175,000 USD
Plano, TX Pay Range
$140,000$175,000 USD

About Collective Health

Collective Health simplifies employee healthcare with an integrated technology solution that makes healthcare work for everyone. With 400,000 member lives and over 70 clients—including Driscoll’s, Pinterest, Red Bull, Restoration Hardware (RH), and more—Collective Health is reinventing the healthcare experience for forward-thinking organizations and their people across the U.S. The company has developed an integrated health benefits platform, and partnered with innovative companies across care delivery and diagnostics to meet the most pressing healthcare challenges for employers today.

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