Regulatory Compliance Program Lead

Health Partners Plans; Philadelphia (Philadelphia County); On-site; USD 90,000 - 140,000; Full time

Job summary

Health Partners Plans is seeking a Compliance Program Manager to oversee compliance across Medicare, Medicaid, CHIP, and ACA. You will align policies with regulations, manage internal and external audits, and drive corrective action plans while promoting accountability and efficiency across departments.

The role requires leading cross-functional teams, monitoring regulatory trends, and enhancing audit readiness.

Qualifications

• Bachelor's degree in a relevant field (Business Admin, Healthcare Admin, Public Health, Compliance, Risk Management, or related).
• 5 years of experience in compliance, auditing, risk management, or regulated healthcare operations.
• Experience coordinating internal and external audits.
• Strong analytical and written/verbal communication skills.
• Project and program management abilities to manage multiple initiatives.
• Audit and monitoring skills with data collection, analysis, reporting.
• Ability to develop and deliver compliance training.
• Strong interpersonal skills and cross-functional collaboration.
• Ability to interpret complex regulations; adapt to changing environments.
• Capacity to work independently and in fast-paced settings.

Responsibilities

• Track and maintain compliance activities across lines of business; support audits and regulatory deliverables.
• Review policies to ensure regulatory alignment.
• Conduct monitoring, auditing and implement action plans.
• Perform scheduled and ad-hoc regulatory audits.
• Lead root-cause analyses and manage corrective measures.
• Provide audit leadership and report findings to executives.
• Prepare teams for internal and external audits and ensure readiness.
• Serve as liaison for Compliance and Operations monthly meetings.
• Identify regulatory risks and drive improvement actions.
• Develop staff training on regulatory requirements.
• Standardize regulatory workflows to improve efficiency.
• Support regulatory reporting and performance initiatives.

Skills

Analytical thinking

Communication

Project management

Audit & monitoring

Training delivery

Conflict resolution

Attention to detail

Interpersonal skills

Leadership

Adaptability

Education

Bachelor's degree in Business Administration / Healthcare Administration / Public Health / Compliance / Risk Management

Job description

Health Partners Plans is seeking a Compliance Program Manager to oversee compliance across Medicare, Medicaid, CHIP, and ACA. You will align policies with regulations, manage internal and external audits, and drive corrective action plans while promoting accountability and efficiency across departments.

The role requires leading cross-functional teams, monitoring regulatory trends, and enhancing audit readiness.