Role Overview:

The Compliance Manager provides oversight of the organization’s internal and regulatory corrective actions on behalf of the Company, helping ensure compliance issues are addressed in a timely, consistent, and sustainable manner. This position plays a key role in strengthening the compliance program by reducing organizational risk, promoting operational accountability, and enhancing visibility into corrective action performance across markets and business areas. The role supports informed leadership decision-making, process improvement, and enterprise readiness. Success in this role requires sound judgment, strong knowledge of Archer, excellent problem-solving and organizational skills, and the ability to communicate effectively with leadership, market compliance teams, business partners, and Shared Services stakeholders.

Work Arrangement:

Remote within the United States, working Eastern Standard Time. For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Responsibilities:

• Oversee the Company’s internal and regulatory corrective action process, including the intake, initiation, monitoring, documentation, and closure readiness of corrective action plans.
• Initiate, coordinate, and manage Shared Services corrective action plans (CAPs), ensuring assigned actions are clearly documented, appropriately tracked, and completed within established expectations.
• Track CAP and Compliance Issue aging, including monitoring overdue items, identifying barriers to timely completion, and escalating risks or delays as appropriate.
• Prepare and provide executive-level reporting on CAP activity, Compliance Issue aging, remediation progress, trends, barriers, risks, and overall corrective action performance.
• Collaborate closely with individual market compliance teams, business owners, and functional stakeholders to support corrective measures, validate remediation activities, and promote accountability for timely resolution.
• Support identification and documentation of root cause to help ensure corrective actions are meaningful, sustainable, and responsive to the underlying compliance issue.
• Maintain and update compliance tables used to support procurement, proposal, and RFP responses, including information related to CAPs, fines, sanctions, remediation activity, and related compliance matters.
• Track loss events, coordinate related follow-up, and evaluate whether additional corrective action, compliance issue documentation, or escalation is needed.
• Use Archer to document, monitor, report, and manage CAPs, Compliance Issues, loss events, remediation activities, and related follow-up in accordance with established processes.
• Analyze CAP, Compliance Issue, and loss event data to identify trends, recurring issues, potential risks, and opportunities for process improvement.
• Communicate clearly and effectively with leadership, market compliance teams, business partners, and Shared Services stakeholders regarding CAP status, expectations, documentation needs, and follow-up actions.
• Apply strong problem-solving, organizational, analytical, and stakeholder-management skills to support timely resolution of compliance issues and continuous improvement of the corrective action process.
• Partner with key stakeholders across lines of business to implement compliance requirements, remediate issues, and strengthen controls.
• Prepare and maintain compliance documentation, including procedures, workflows, evidence of monitoring, and reporting artifacts.
• Contribute to compliance program governance, including periodic reporting, committee/leadership updates, and support for compliance risk assessment.

Education/Experience:

Bachelor’s Degree in Business, Social Science, or relevant field required. Legal background helpful. 3+ years in a managed healthcare environment required, including experience in the areas of compliance oversight preferred. Minimum of 1 year of supervisory experience required. Knowledge of compliance concepts and practices (strategies, control activities, information analysis, reporting, and communication) is preferred. Strong analytical and research skills, able to synthesize information to provide practical solutions to accomplish meaningful results. Self-motivated with demonstrated project management skills. Extensive experience managing large amounts of data and creating leadership-level data reports. Certified in Healthcare Compliance preferred. Proficient with Microsoft Office products. Excel, Word, PowerPoint, SharePoint.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.