Compliance Manager, Governance and Enablement

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $100k - $115k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Serve as the operational integrator of the HealthEdge Compliance and Privacy Department • Coordinate governance, manage strategic initiatives, support enterprise risk management, facilitate reporting, and ensure departmental accountability • Manage governance forums, agendas, decision logs, action tracking, and governance documentation • Support strategic departmental priorities from planning through implementation • Monitor cross-functional dependencies and escalate risks to leadership • Support compliance governance frameworks, routines, and operating practices • Partner with business, compliance, legal, and operations teams to embed compliance requirements into business processes • Coordinate departmental KPIs and executive dashboards and monitor performance against strategic objectives • Support Compliance communication channels, including SharePoint, hotline, and email channels • Improve governance processes and operational efficiency • Develop standardized workflows, templates, operating procedures, job aids, reporting materials, and process documentation • Simplify and standardize compliance processes with stakeholders • Support change management and communications for new or changing compliance requirements • Promote accountability, transparency, risk awareness, and compliance ownership

🎯 Requirements

• Bachelor’s degree in Business, Healthcare Administration, Compliance, Risk Management, Human Resources, Operations, or related field, or equivalent work experience • Typically 5+ years of experience in compliance, governance, risk management, operations, audit, quality, project management, or related function • Experience supporting compliance governance routines, issue tracking, documentation, reporting, or audit readiness • Strong written and verbal communication skills • Strong organizational, stakeholder management, and follow-through skills • Ability to manage multiple priorities, track deliverables, and meet deadlines • Experience working cross-functionally with business, compliance, legal, audit, risk, or operational teams • Ability to interpret compliance requirements and translate them into practical business processes • Ability to manage governance routines, action logs, deliverables, and stakeholder follow-up • Ability to build trusted relationships and influence without direct authority • Ability to maintain confidentiality and handle sensitive information appropriately • Working knowledge of compliance governance, risk management, audit readiness, and internal controls • Understanding of issue management, corrective action planning, remediation tracking, and root cause analysis • Familiarity with compliance reporting, metrics, dashboards, and executive-level status updates • Knowledge of change management and communication practices • Proficiency with Microsoft Office, including Excel, PowerPoint, Word, Teams, and SharePoint • Familiarity with tools such as Smartsheet, Jira, Power BI, or similar platforms preferred • Certification such as CCEP or CHC preferred • Experience in healthcare, managed care, payer operations, shared services, HR operations, or regulated environments preferred • Candidates may be required to complete a pre-employment criminal background check

🏖️ Benefits

• Remote work environment • Hybrid or remote work environment • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities • Equal opportunity employer committed to workforce diversity