Compliance Improvement Manager

🔥 21 hours ago

🐊 Florida, Iowa, +2 more states – Remote

🐊 Florida – Remote 🌾 Iowa – Remote ⚜️ Louisiana – Remote 🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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HealthPlanOne

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2006

⚕️ Healthcare Insurance

🏪 Marketplace

Healthcare Insurance • Marketplace

HealthPlanOne is a technology-enabled healthcare services company that helps millions of consumers and agents navigate and shop for Medicare plans. It specializes in Medicare education, digital marketing, lead generation, and broker/health-plan partnerships, using analytics and customer-focused agent support to simplify complex insurance choices. The company supports agents and partners with licensing, marketing, and platform tools to connect consumers with appropriate Medicare options.

📋 Description

• Support compliance and performance strategy by implementing CMS and carrier aligned initiatives and guiding process improvements that enhance regulatory adherence and operational efficiency • Monitor compliance trends and analytics by reviewing KPIs, audit results, coaching data, CTM activity, and retention patterns to identify risks and improvement opportunities • Lead compliance coaching and retraining for agents and leaders while overseeing a team that supports preparation and monitoring and will eventually assist in coaching and remediation activities • Partner with internal teams on training, scripting, and call-flow alignment to ensure compliance accuracy and consistent application of regulatory requirements across materials and workflows • Enhance operational and compliance processes by collaborating with cross-functional teams to streamline workflows, reduce inefficiencies, and strengthen adherence to CMS and carrier guidelines • Provide audit, remediation, and reporting support by reviewing audit and performance trends, developing corrective strategies, and participating in carrier compliance reviews with concise, data-driven insights • Independently manage all carrier-facing compliance communication by representing the Compliance department during carrier meetings, reviews, and external partnership discussions • Perform other related duties as assigned to support compliance initiatives and organizational effectiveness

🎯 Requirements

• Bachelor’s degree or equivalent 6 years’ experience in Medicare Advantage, Prescription Drug Plan and Regulatory Compliance in healthcare or insurance • Strong knowledge of CMS regulations, Medicare compliance standards, and carrier requirements • Familiarity with audit & monitoring tools for compliance tracking and performance improvement • Experience in risk management, compliance reporting, and process optimization • The ability to collaborate with training teams and leadership to ensure compliance and performance initiatives are effectively communicated and adopted • Strong oral and written communication skills for supporting training development and compliance discussions • Ability to analyze compliance and performance trends, identify areas of improvement, and assist in implementing improvement programs • Experience in trend analysis, remediation support, and compliance monitoring

🏖️ Benefits

• Equal Employment Opportunity (EEO) is a fundamental principle at HealthPlanOne • HealthPlanOne requires the necessary drug testing and background checks as part of our pre-employment practices