• Define and evolve Clover Health’s security governance and risk management strategy, aligning function-level priorities with enterprise objectives and the security roadmap. • Establish a risk-driven approach to governance aligned with HIPAA Security and Privacy Rules, NIST Cybersecurity Framework (CSF) v2, and NIST AI Risk Management Framework (AI RMF), where applicable. • Anticipate security and regulatory risks 12+ months out, using business, product, regulatory, and market signals to inform strategy and tradeoffs. • Ensure security risk decisions are clearly framed, documented, and communicated in business terms for executive and board-level audiences. • Assist the CISO in setting security risk priorities, framing tradeoffs, and communicating risk posture and progress to executive leadership and the Board. • Own Clover Health’s security compliance posture as a public healthcare company, including federal and state regulatory obligations. • Lead security-related audits, assessments, and regulatory inquiries in partnership with Legal, Compliance, Privacy, and Internal Audit. • Drive clarity, consistency, and maturity in security policies, standards, and procedures. • Ensure compliance efforts are proactive, scalable, integrated into how Clover Health builds and operates products, and maintained over time to support ongoing audit readiness and regulatory expectations. • Own high-stakes outcomes for the GRC function, ensuring accountability across internal partners and third-party providers. • Lead Clover Health’s third-party security risk management program end-to-end.

• Own and evolve the global regulatory compliance strategy across all regions and product lines. • Leverage AI‑enabled regulatory intelligence tools to monitor regulatory changes and assess product impact. • Ensure compliance with UL, FCC, CE, RoHS, REACH, Prop 65, and other applicable standards. • Lead regulatory audits, certifications, and technical submissions using digitized compliance evidence systems. • Embed compliance requirements early in product architecture through close partnership with Engineering and Product teams. • Lead the corporate product safety program, including hazard analysis, FMEA, risk mitigation, and field actions. • Deploy data‑driven and AI‑assisted risk assessment methods to identify emerging safety issues. • Oversee investigations, RCA, and CAPA using advanced analytics across field, manufacturing, and reliability data. • Establish predictive safety metrics and dashboards for executive review. • Own enterprise ISO frameworks (ISO 9001, 14001, 45001, etc.). • Lead the transformation toward a digital, AI‑enabled QMS. • Partner with global functions and manufacturing partners to ensure consistent QMS execution. • Own and govern the enterprise PLCM framework and stage‑gate process. • Implement AI‑driven launch readiness and risk scoring across NPI programs. • Provide executive visibility through integrated dashboards, predictive KPIs, and automated gate reviews. • Champion a quality‑first, data‑driven, and AI‑augmented culture across Engineering, Operations, Supply Chain, and Service. • Drive KPI governance using advanced analytics and trend‑based insights. • Influence senior leaders through clear, evidence‑based recommendations.

About Us Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review. At IntegrityM, we offer a culture of opportunity, recognition, collaboration, and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees’ professional development. Large company perks…Small company feel! www.integritym.com In this role, the Medicaid Audit and Compliance Specialist will be responsible for performing and reporting on Medicaid Managed Care Plans and providers to identify potential fraud, waste, and abuse; issue findings and recommendations; and identify improper payments. Audit assignments can be programmatic or financial and may range from desk reviews and/or onsite review activities as determined by federal and state regulations. Specific review types may include case management, program payment appropriateness, program and policy compliance, billing, coding and medical record documentation reviews, as well as research and analysis of industry trends. The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but are not limited to performing licensing and exclusion reviews on providers and work with the medical staff to ensure services are reimbursed meet regulatory requirements. The Medicaid Audit and Compliance Specialist will work independently as well as collaboratively with other audit staff.    Job Responsibilities:   - Applies in-depth knowledge of federal and state regulations and healthcare industry standards.    - Comprehends and follows auditing plans and methodologies specific to contract requirements.     - Prioritization and assignment of workload, ensuring adherence to task order policies and procedures.    - Examines and calculates data from financial documents and statements such as provider cost reports as a method of audit.     - Utilize data mining and trend analysis tools to detect anomalies in Medicaid billing and payment patterns.    - Attend on-site audits to retrieve medical records and conduct provider entrance/exit conference.     - Prepare and submit medical record request letters to providers associated with requests for medical record requests or suspension overpayment determinations.    - Interpret and apply pertinent laws, regulations, policies, and procedures relevant to the specific audit findings and provider type being audited.    - Ensure Generally Accepted Government Auditing Standards (GAGAS) standards are applied to each applicable audit to identify fraud, waste or abuse.    - Preparing factual and objective written reports in conformance with professional auditing and evaluation standards and present findings to leadership, external agencies, and government partners.    - Calculates improper payments, and issues findings, recommendations, and corrective actions in accordance with applicable regulations, policies and procedures.     - Prepare and send suspension overpayment determinations to providers when applicable.     - Communicates with federal/state agencies and providers regarding issues such as general regulatory compliance, audit findings, and the recovery process.    - Attends briefings and presentations as assigned.    - Maintains fraud case development quality standards so that proper case development is ensured, and quality cases are fully prepared.     - Maintains proper and timely updates in appropriate tools and applications for their investigations. Case development databases and documents.    - Develops and documents reports of investigative findings, compiles case file documentation, calculates improper payments, and issues findings, recommendations, and corrective actions in accordance with applicable regulations, policies and procedures.     - Program research relating to federal program applications, eligibility, payments, and other program requirements.     - Conducts on-site visits and/or interviews as required for investigation.     - Identify weaknesses in current audit processes and recommend enhancements for improved efficiency and effectiveness.    - Performs ad hoc tasks/duties as assigned.

Regulatory Operations Lead: 26-00998 Primary Skills: Regulatory operations (Expert), SQL (Advanced), Risk Mitigation (Advanced), Stakeholder Management (Expert), Data Visualization (Expert) Contract Type: W2 Duration: 12 Months Location: San Francisco, CA (Remote) Pay Range: $137.76 - $142.76 Per hour Job Summary: We are seeking a highly experienced Regulatory Operations Lead to drive the strategy, development, and execution of global regulatory programs and products. This role will play a critical part in ensuring compliance across multiple jurisdictions while supporting scalable business growth. The ideal candidate will bring deep expertise in regulatory operations, strong analytical capabilities, and the ability to influence cross-functional teams and senior leadership in a complex, fast-paced environment. Key Responsibilities: - Lead the strategic development and execution of scalable regulatory products and programs across global markets - Drive end-to-end delivery of regulatory initiatives, ensuring compliance with evolving legal and policy requirements - Analyze data using SQL and BI tools to identify trends, investigate anomalies, and generate actionable insights - Translate regulatory changes and trends into business strategies and recommendations for senior leadership - Partner with cross-functional teams (legal, policy, product, and engineering) to design and implement automated compliance solutions - Identify, assess, and mitigate regulatory risks, including leading incident resolution and escalation strategies - Develop and operationalize regulatory workflows and processes to improve efficiency and scalability - Influence product roadmaps and organizational strategy through regulatory expertise - Build dashboards and reporting mechanisms to support decision-making and performance tracking - Lead high-impact strategic initiatives aligned with business growth and compliance objectives Must-Have Skills: - 10+ years of experience in regulatory operations, compliance, program management, or related fields - Strong experience working in complex, fast-paced, and highly regulated environments - Proficiency in SQL, data analysis, and BI tools (e.g., Tableau, Power BI) - Experience building scalable systems and processes for regulatory compliance - Strong stakeholder management and ability to influence senior leadership - Excellent communication skills with the ability to simplify complex regulatory concepts - Proven ability to manage multiple projects and navigate ambiguity effectively Industry Experience: - Experience in regulated industries such as technology, marketplaces, fintech, or compliance-driven environments - Prior experience supporting global regulatory frameworks and multi-jurisdictional compliance - Experience working with cross-functional teams including legal, policy, product, and engineering - Familiarity with platform-based or high-growth organizations is preferred