Posted 15 days ago
Sr. Manager, Corporate Compliance
AI Summary
Executes and operationalizes the corporate compliance program for a health plan, embedding regulatory requirements into business processes and managing issue remediation.
About this role
Overview
The Senior Manager, Corporate Compliance is responsible for first-line execution and operationalization of Sendero Health Plan’s compliance program. This role ensures that regulatory requirements are effectively implemented into business processes and day-to-day operations across the organization and its vendor network.
The Senior Manager, Corporate Compliance serves as the primary compliance execution partner to business units— providing guidance, managing regulatory change implementation, supporting issue remediation, and reinforcing compliance accountability. This role works in close coordination with the Senior Manager, Auditing, Monitoring & Vendor Oversight, who independently monitors, tests, and validates the effectiveness of compliance controls. Together, the two roles form a clear and defensible model of execution versus independent assurance, consistent with CMS Marketplace and TDI regulatory expectations.
Responsibilities
Essential FunctionsCompliance Program Execution (First Line Ownership)• Execute assigned elements of the compliance program in alignment with established policies, procedures, and regulatory requirements.• Support compliance leadership in implementing approved compliance work plans and enterprise risk priorities.• Ensure compliance requirements are embedded into operational workflows and business practices.Regulatory Implementation & Change Management• Monitor federal and state regulatory guidance, including ACA, CMS Marketplace requirements, and TDI rules.• Translate regulatory changes into actionable implementation steps for business units.• Partner with operational leaders to ensure timely and accurate adoption of regulatory requirements.Issue Management & Remediation Ownership• Serve as the first line owner for compliance issue intake, documentation, and coordination of remediation.• Support root cause analysis and corrective action development with business owners.• Track remediation implementation and coordinate with auditing and monitoring partners for validation and closure.Coordination with Monitoring & Auditing (Second Line Interface)• Act as the primary execution side liaison to the Senior Manager, Auditing, Monitoring & Vendor Oversight.• Support business areas in preparing for compliance monitoring activities, audits, and examinations.• Facilitate responses to findings and ensure remediation actions are implemented as designed.Delegated Entity & Vendor Compliance Execution• Support day to day compliance execution for vendors and delegated entities in coordination with Vendor Management.• Reinforce vendor understanding of compliance obligations, documentation standards, and corrective action expectations.• Coordinate vendor remediation activities resulting from monitoring, audits, or regulatory reviews.Training & Compliance Enablement• Support development and delivery of compliance training for employees and vendors, as appropriate.• Coordinate targeted education based on regulatory changes, recurring findings, or risk trends.• Promote awareness of compliance responsibilities, standards of conduct, and reporting expectations.Cross Functional Support & Reporting• Partner with Operations, Medical Management, Network, Finance, IT, and Vendor Management to support compliant operations.• Prepare compliance documentation, remediation summaries, and activity reports for leadership.• Escalate compliance risks and concerns in accordance with established governance protocols.Knowledge, Skills and Abilities:
- Regulatory implementation and operational compliance
- Compliance issue remediation
- Vendor compliance execution
- Cross functional coordination
- Documentation and accountability
- Clear written and verbal communication
Qualifications
Required Education:
- Bachelor's Degree (higher degree accepted) in healthcare administration, business, law, or a related field.
Required Experience:
- 6 years of experience in healthcare compliance or a regulated healthcare environment.
- Working knowledge of ACA, CMS Marketplace requirements, and state insurance regulations.
- Experience supporting regulatory implementation, compliance remediation, or audit readiness.
- Strong organizational, analytical, and communication skills.
Skills
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