Executive VP, Enterprise Compliance & Risk

Mass General Brigham Health Plan; Somerville (MA); Hybrid; USD 250,000 - 300,000; Full time

Job summary

Mass General Brigham Health Plan is seeking an executive to lead the organization's enterprise compliance program across all lines of business, including Commercial, Medicaid, Medicare Advantage, and DSNP. The role partners with senior leadership and the Board to identify and manage compliance risks, ensuring ethics and accountability.

The ideal candidate has 12+ years in healthcare compliance with strong leadership, regulatory affairs experience, and a track record in audits, investigations,

Qualifications

• Bachelor's degree in Healthcare Administration, Public Health Law, Business or related field plus 12+ years of related experience.
• Master's degree or JD strongly preferred.
• 12+ years of progressive experience in healthcare compliance, regulatory affairs, or risk management
• 7+ years of leadership experience in a complex, multi-line healthcare organization or health plan
• Deep expertise across government programs (Medicare Advantage, Medicaid, DSNP) and commercial products
• Experience interacting with regulatory agencies and leading audits and investigations

Responsibilities

• Develop and lead an enterprise-wide compliance program aligned with regulatory requirements and business strategy.
• Establish governance structures, including executive-level committees and Board reporting.
• Ensure integration of compliance across all lines of business (Commercial, Medicaid, Medicare Advantage, DSNP).
• Drive continuous improvement of the compliance framework in response to regulatory changes and organizational priorities.
• Provide oversight of compliance with federal and state healthcare regulations, including CMS, Medicaid, and commercial requirements.
• Lead enterprise risk assessment processes to identify, prioritize, and mitigate compliance risks.
• Ensure alignment with accreditation standards and regulatory expectations across all products.
• Stay current on regulatory changes and proactively guide operational leadership on implications.
• Oversee enterprise compliance auditing and monitoring activities, including vendor and FDR oversight where applicable.
• Ensure implementation of corrective action plans and validation of remediation effectiveness.
• Lead or oversee investigations into potential compliance violations, coordinating with Legal as appropriate.
• Ensure reporting mechanisms (e.g., hotline, internal reporting) are effective and trusted.
• Establish and maintain enterprise compliance policies and standard.
• Lead development and execution of compliance education and training programs across all employee populations.
• Partner with Learning & Development on training program training creation and delivery.
• Promote a culture of compliance, ethics, and accountability across the organization.
• Ensure leaders are equipped to operationalize compliance requirements within their functions.
• Serve as a trusted advisor to executive leadership on compliance and regulatory matters.
• Present compliance program performance, risks, and key issues to executive leadership and the Board of Directors.
• Act as primary liaison with regulatory agencies during audits, reviews, and investigations.
• Partner cross-functionally with Legal, Operations, Clinical, Finance, and HR to ensure compliance integration.
• Build, lead, and develop a high-performing compliance organization, including regulatory, Medicare/Medicaid compliance, and audit functions.
• Establish clear goals, performance expectations, and talent development strategies.
• Foster an inclusive, high-accountability culture aligned with organizational values.
• Hold self and others accountable to meet commitments.
• Focuses on collaboration and connection to contribute to a high performing workplace.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.

Skills

Healthcare compliance

Regulatory affairs

Risk management

Leadership

Auditing

Regulatory engagement

Regulatory communication

Education

Bachelor's degree in Healthcare Administration/related field

Master's degree or JD preferred

Job description

Mass General Brigham Health Plan is seeking an executive to lead the organization's enterprise compliance program across all lines of business, including Commercial, Medicaid, Medicare Advantage, and DSNP. The role partners with senior leadership and the Board to identify and manage compliance risks, ensuring ethics and accountability.

The ideal candidate has 12+ years in healthcare compliance with strong leadership, regulatory affairs experience, and a track record in audits, investigations,