Healthcare Compliance Program Lead

Jefferson Health Plans; Philadelphia (Philadelphia County); On-site; USD 110,000 - 140,000; Full time

Job summary

Health Partners Plans, Inc. is seeking a Compliance Program Manager to oversee compliance across Medicare, Medicaid, CHIP, and ACA. You will ensure policies align with regulations, manage audits, and lead corrective actions while driving risk management and operational improvements.

This role partners with Operations to maintain audit readiness and a culture of accountability. The position requires strong analytical skills, stakeholder collaboration, and the ability to manage multiple audits and

Qualifications

• Bachelor’s Degree in a relevant field such as Business Administration, Healthcare Administration, Public Health, Compliance, Risk Management, or a related field
• 5 years of experience in compliance, auditing, risk management or healthcare operations
• Strong analytical and communication skills
• Project and program management abilities
• Audit and monitoring capabilities
• Ability to develop and deliver effective compliance training

Responsibilities

• Oversee compliance activities across all lines of business (Medicare, Medicaid, CHIP, ACA)
• Ensure policies and procedures align with regulatory requirements
• Manage internal and external audits and develop corrective action plans
• Monitor compliance activities and regulatory reporting
• Identify compliance risks and drive operational improvements
• Serve as liaison between Compliance and Operations teams
• Prepare teams for internal and external regulatory audits
• Support training and education on regulatory requirements
• Improve efficiency by standardizing regulatory workflows
• Deliver regulatory reporting and performance initiatives

Education

Bachelor’s Degree in a relevant field

Job description

Health Partners Plans, Inc. is seeking a Compliance Program Manager to oversee compliance across Medicare, Medicaid, CHIP, and ACA. You will ensure policies align with regulations, manage audits, and lead corrective actions while driving risk management and operational improvements.

This role partners with Operations to maintain audit readiness and a culture of accountability. The position requires strong analytical skills, stakeholder collaboration, and the ability to manage multiple audits and