Director, Health Plan Compliance & Regulatory (Remote)

Ankura; United States; Remote; USD 180,000 - 250,000; Full time

Job summary

Ankura is seeking a Director to lead complex compliance and operational advisory engagements for health plans across Medicare Advantage, Medicaid managed care, and ACA marketplace programs. You will serve as a senior SME on CMS guidance, state requirements, and marketplace regulations, guiding engagement teams and senior client relationships.

You will grow the practice through proposals, scoping new engagements, and collaborating with Managing Directors to expand capabilities and market

Qualifications

• Bachelor’s degree from an accredited college or university.
• Significant relevant experience in health plan compliance, regulatory affairs, health plan operations, consulting, or regulatory advisory services.
• Deep knowledge of Medicare Advantage, Medicaid managed care, ACA marketplace programs, or related health care programs.
• Strong working knowledge of CMS guidance, Medicaid requirements, marketplace regulations, and health plan obligations.
• Experience leading regulatory audits, compliance assessments, or corrective action planning.
• Ability to interpret complex regulatory requirements and apply to health plan operations.
• Experience leading complex consulting engagements with scope, staffing, budgets, timelines, and deliverables.
• Proven ability to manage senior client relationships and advise executive stakeholders.
• Excellent written and verbal communication skills.
• Ability to travel based on client and engagement needs.

Responsibilities

• Lead complex compliance and operational advisory engagements for health plans across Medicare Advantage, Medicaid, and ACA marketplaces.
• Direct regulatory audits, program integrity reviews, compliance assessments, and corrective action planning.
• Serve as a senior SME on CMS guidance and marketplace requirements and apply them to client operations.
• Translate regulatory requirements into practical recommendations and operational solutions.
• Develop engagement approaches, scopes, work plans, timelines, resources, and deliverable strategies.
• Oversee multiple workstreams, ensuring quality, timeliness, and budget adherence.
• Identify compliance and operational risks and provide actionable mitigation strategies.
• Lead the development of audit findings, reports, and client deliverables for regulators and counsel.
• Present complex findings to executives and manage risk communications.
• Support business development and proposals with market insights and capabilities.

Skills

Analytical thinking

Communication

Leadership

Project management

Multitasking

Education

Bachelor’s degree

Advanced degree (preferred)

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Ankura is seeking a Director to lead complex compliance and operational advisory engagements for health plans across Medicare Advantage, Medicaid managed care, and ACA marketplace programs. You will serve as a senior SME on CMS guidance, state requirements, and marketplace regulations, guiding engagement teams and senior client relationships.

You will grow the practice through proposals, scoping new engagements, and collaborating with Managing Directors to expand capabilities and market