CX Business Compliance Liaison

Job not on LinkedIn

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $84.8k - $121.1k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🚔 Compliance

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Support the Director of CX Business Compliance in translating approved requirements into consistent, evidence-based practices across Customer Experience accounts • Provide day-to-day compliance oversight, consultative guidance, escalation coordination, reporting, and implementation support for member and provider account access, provider EFT, and portal administrator changes • Provide functional oversight of verification-review activities performed by Verification Specialists and Senior Verification Specialists • Monitor adherence to approved requirements, identify control gaps and recurring issues, provide compliance guidance, and escalate findings • Coordinate reviews of account work and independent quality reassessments • Support audit-the-auditor reviews, sampling, calibration, root-cause analysis, and corrective-action validation • Monitor authentication, identity and representative authority validation, trusted contact sources, outbound verification, approved scripts, and recording requirements • Serve as an escalation contact for complex, disputed, incomplete, or high-risk matters, including potential fraud, privacy, or security concerns • Partner with Privacy, Security, Legal, Risk and Compliance, Operations, Quality, Technology, Training, implementation teams, and account leadership • Support quality monitoring and secret shopper programs, communicate findings, coordinate corrective actions, and track recurring issues through resolution • Draft and maintain policies, SOPs, scripts, checklists, and work aids • Coordinate role-based training, knowledge checks, access requirements, refresher training, and production-readiness activities • Support new-account implementations by aligning procedures, controls, training, reporting, escalation paths, and required approvals • Gather and validate compliance data, report trends, risks, corrective-action status, and readiness gaps, and maintain secure records and audit trails • Provide backup support to maintain CX Business Compliance activities and document actions and handoffs

🎯 Requirements

• Bachelor's degree or an equivalent combination of education and relevant experience • Nine or more years of experience in healthcare operations, compliance, privacy, quality assurance, risk management, or a related area • Experience working in a HIPAA-regulated environment and applying privacy, confidentiality, and information-handling requirements • Experience reviewing business processes, documentation, or operational practices to identify compliance gaps • Experience writing, developing, and maintaining policies, procedures, SOPs, or other controlled documentation • Experience translating regulatory, contractual, or company requirements into practical business processes and controls • Project management experience coordinating initiatives, priorities, and issue resolution across multiple teams or business areas • Experience analyzing findings, identifying trends or root causes, tracking corrective actions, and communicating risks and recommendations to business leaders • Proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint • Experience in Medicaid, healthcare compliance, privacy, provider operations, or member operations • Experience supporting compliance monitoring, quality reviews, audits, corrective-action programs, or process improvement initiatives across multiple accounts or business areas • Experience supporting new implementations, operational readiness, policy or SOP governance, training, or leadership reporting • Familiarity with CXone, Motif, or similar case management, interaction review, verification, or reporting tools • Compliance, privacy, security, or project management certification such as IAPP CIPP, CIPM, CIPT, PMP, CISA, CISM, or comparable certification

🏖️ Benefits

• Work flexibility • Learning and career development • Up to 10% travel opportunity • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies

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