PacificSource Health Plans logo
PacificSource Health Plans

Putting members first since 1933.

Regulatory and Reporting Specialist

ComplianceComplianceFull TimeRemoteMid LevelTeam 1,001-5,000Since 1933H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

$45.0K - $72.0K / year

Seniority

Mid Level

No structured requirement data.

Job Description

Regulatory and Reporting Specialist

PacificSource Health Plans

Role Description Support all aspects of the Grievance and Appeals (G&A) compliance program for Medicare and Medicaid lines of business. Assume the primary role of interfacing with the Compliance department, Auditors, Vendors, and G&A staff for purposes of monitoring and ensuring compliant operations. Interface with the Compliance Department and Fraud, Waste and Abuse teams to evaluate and address fraudulent activities impacting the G&A Department. Conduct internal audits, support external audits, develop policies and procedures, and ensure departmental compliance. - In partnership with Compliance staff and G&A leadership, develop auditing and monitoring plans to assess compliance with all State, Federal, and internal business rules and regulations. - Serve as an inter-departmental liaison for compliance and FWA activities. - Inform all business operations and workflow decisions to ensure that programs are compliant with State, Federal, and internal business rules and regulations. - Be fully informed and ensure compliant processes are in place on all G&A business operations, including but not limited to: - Appeals and Grievance processing - OIG status - FWA programs - Helpdesk operations including call monitoring - Communication strategies - Website publications - Claims adjudication - All vendor managed programs - Maintain a current working knowledge of all applicable Medicare and Medicaid rules and regulations including assessment, impact report, and training on any new rules or regulations to all impacted departments. - Conduct frequent monitoring activities of all G&A business operations, publish results, and report out to G&A Leadership, Compliance Department, quality committees, and other PacificSource leadership teams as applicable. - Respond to all compliance-related inquiries from internal Compliance Department Staff and external Auditors in a timely, professional, and accurate manner to ensure minimal organizational and operational impact. - Work collaboratively with G&A leadership to produce and monitor department policies and procedures as applicable and ensure their regular maintenance to reflect new practices and guidance. - Provide interpretation, training, and implementation of Medicare and Medicaid regulations and communicate them appropriately with respective departments and teams. - Attend weekly meetings; review and approve external communications; and monitor operational performance reports. - Support ongoing communication efforts, maintaining compliant member, G&A, and provider communications. Keeping letters and other member communications up to date with compliance guidance and best practices. Qualifications - Minimum of two years of Grievance and Appeals related health insurance experience required. - Strong preference for experience in auditing or compliance related role. - High school diploma or equivalent required; Bachelor’s degree preferred. Requirements - Strong computer skills. - Excellent verbal and business writing skills. - Excellent public relations skills. - Good understanding of Medical Terminology required. - Ability to define and prioritize problems and manage workload without direct supervision. Benefits - Base Range: $44,982.98 - $71,972.77 - Compensation Disclaimer: The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Company Description PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information, or age. - PacificSource values the diversity of our community, including those we hire and serve. - We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected, and responded to in ways that fully develop and utilize each person’s talents and strengths.

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Corebridge Financial logo

Advertising Compliance Specialist

Corebridge Financial

Corebridge Financial is one of the nation’s largest providers of retirement planning solutions and insurance products. Formerly known as AIG Life & Retirement

Compliance2 days ago

Title: Advertising Compliance Specialist Location: 2929 Allen Parkway, Houston, TX Hybrid Full-time Job Description: Who We Are At Corebridge Financial, we believe action is everything. That’s why every day we partner with financial professionals and institutions to make it possible for more people to take action in their financial lives, for today and tomorrow. We align to a set of Values that are the core pillars that define our culture and help bring our brand purpose to life: - We are stronger as one: We collaborate across the enterprise, scale what works and actdecisively for our customers and partners. - We deliver on commitments: We are accountable, empower each other and go above and beyond for our stakeholders. - We learn, improve and innovate: We get better each day by challenging the status quo and equipping ourselves for the future. - We are inclusive: We embrace different perspectives, enabling our colleagues to make an impact and bring their whole selves to work. Who You’ll Work With Corebridge Financial is a unique franchise that brings together a broad portfolio of life insurance, retirement and institutional products offered through an extensive, multichannel distribution network. It holds longstanding, leading market positions in many of the markets it serves in the U.S. The Corebridge Financial Global Legal, Compliance, Regulatory and Government Affairs department is comprised of attorneys and other professionals providing high quality advisory and transactional support with integrity and objectivity across all parts of the organization. The team ensures an operating environment that minimizes legal, regulatory and reputational risks and complies with all laws and regulations and Corebridge Financial policies & procedures. This is a global, diverse and award-winning team that has been recognized for its leadership and innovative solutions. You will also be able to participate in the Corebridge Financial award-winning pro bono program. 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Responsibilities - Marketing & Advertising Review - Review and approve advertising and marketing materials across channels, including: - Social media platforms (organic and paid) - Websites, landing pages, microsites - Email and digital campaigns - Video, audio, and influencer-related content - Evaluate materials for compliance with applicable federal and state regulations, internal policies, and brand standards. - Ensure disclosures, disclaimers, and required regulatory language are accurate, clear, and appropriately displayed across platforms. - Social Media & Digital Risk Oversight - Assess social media content for platform-specific compliance risks, including: - Character-limited disclosures - Hashtags and tagging practices - Testimonials, endorsements, and influencer content - Real-time and reactive marketing posts - Partner with Marketing and Digital teams to develop compliant approaches for emerging social trends and new platforms. - Support monitoring, issue identification, and remediation related to social media activity. - ADA & Accessibility Support - Review digital marketing materials for accessibility considerations, including: - Website and landing-page accessibility - Social media image alt-text and video captioning - Readability, contrast, and usability standards - Support alignment with recognized accessibility frameworks (e.g., WCAG standards) and internal accessibility guidelines. - Partner with Digital, UX, and Legal teams to identify and remediate accessibility gaps. - Advisory & Partnership - Serve as a trusted compliance partner to Marketing, Digital, and Product teams by providing practical, timely guidance. - Participate in project planning and campaign reviews to identify compliance and accessibility considerations early. - Assist with training and awareness efforts related to marketing compliance, social media risk, and accessibility expectations. - Documentation & Reporting - Maintain accurate documentation of reviews, approvals, and issue resolution. - Support reporting, metrics, and trend analysis related to marketing and social media compliance. - Assist with regulatory inquiries, audits, and internal reviews as needed. - Review retail communications, corporate, advisory and broker dealer, training, presentations and other materials for compliance with all applicable regulations - Understand the impacts of advertising regulations on various advertising and marketing mediums including but not limited to print, electronic, web-based, and social media platforms - Provide back up to team members on other business line materials, time and capacity permitting - Build and manage relationships with Marketing, Sales, Product Management, and Compliance teams - Develop and deliver advertising compliance training to Marketing and other Business partners periodically - Represent Advertising Compliance on project working groups for new products, branding initiatives and separation - Research, train and advise on new or updated regulations which can impact advertising compliance - Conduct oversight and spot checking of materials approved with changes to ensure Marketing has made required changes Skills & Qualifications - FINRA Series 7 & 24 or 6 & 26 Required - College degree or evidence of advanced industry education preferred (e.g., professional designations such as the ChFC, LUTCF, CFP, etc.) - Minimum 1 years of advertising compliance experience or 3 years relevant work experience - Minimum 5+ years of financial industry experience (insurance, broker-dealer and/or registered investment adviser) - Ability to think strategically about the impacts of advertising regulations and issues across the organization - Intermediate knowledge of FINRA Rules 2210, 2211, 2212, 2213, 2214, SEC Rules 206(4)-1, 230.482, NAIC Model Regulations 570, 582 & 245 - Ability to focus on what matters most and drive toward a common goal while keeping materials compliant - Ability to negotiate and identify solutions to problems - Ability to prioritize and execute on a high-volume of work - Strong Analytical skills Work Location This position is based in Corebridge Financials' Houston, Texas office and is subject to our hybrid working policy, which gives colleagues the benefits of working both in an office and remotely. 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These Company contributions vest immediately. - Employee Assistance Program: Confidential counseling services and resources are available to all employees. - Matching charitable donations: Corebridge matches donations to tax-exempt organizations 1:1, up to $5,000. - Volunteer Time Off: Employees may use up to 16 volunteer hours annually to support activities that enhance and serve communities where employees live and work. - Paid Time Off: Eligible employees start off with at least 24 Paid Time Off (PTO) days so they can take time off for themselves and their families when they need it. Eligibility for and participation in employer-sponsored benefit plans and Company programs will be subject to applicable law, governing Plan document(s) and Company policy. We are an Equal Opportunity Employer Corebridge Financial, is committed to being an equal opportunity employer and we comply with all applicable federal, state, and local fair employment laws. 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Texas

Research Compliance Analyst

University of California

Since 1869, the University of California has been providing excellent college educational programs for students seeking bachelor's to doctoral degrees. The Univ

Compliance2 days ago

Research Compliance Analyst (RSCH CMPLNC ANL 3 RP) Location: Davis, California Work Type: Hybrid Employment Type: Full-time, Career Work Schedule: Monday–Friday, 8:00 AM–5:00 PM Salary: $77,100–$139,900 annually Job Description Job Summary Under the direction of the IACUC Administration Office Assistant Director: perform inspections of animal facilities and PI laboratories; evaluate programs of animal care and use; review animal research projects-in-progress. Responsible for reviewing and editing new research proposals and amendments to existing proposals to ensure consistency with federal and state laws and regulations, and university policies as they pertain to the use of animals in research and teaching; conduct post approval monitoring. Share IACUC Administration Office responsibilities including responding to public record requests, facilitating and/or participating on IACUC subcommittees, departmental and campus work groups; draft policies and guidelines. Provide IACUC Office general function support including but not limited to participating in the IACUC Administration on-call program, IACUC web page development and maintenance, Animal Tracking System (ATS) oversight, management of protocol expirations, annual renewals and personnel training reminder notifications. Act as a liaison and escort for USDA Animal Welfare, Federal and State inspectors during campus visits, and AAALAC site visits. Coordinate corrections of deficiencies cited by regulators. May serve as an alternate IACUC voting member. This position may be eligible for hybrid remote work arrangements. Qualifications Minimum Qualifications - For full consideration, applicants are encouraged to upload license and/or certification if required of the position - Required to hold a valid California driver's license, have a driving record that is in accordance with local policies/procedures, and/or enroll in the California Employer Pull Notice Program - Bachelor’s degree in related areas and/or equivalent experience/training. - Experience evaluating animal care programs and facilities. - Experience working in the field of laboratory animal science. - Experience working with pertinent laws, regulations, guidelines, and policies dealing with the humane care and use of animals in research and teaching, including the Federal Animal Welfare Act, the US Public Health Service Policy on the Humane Use of Laboratory Animals, and familiarity with the requirements of the California Fish & Wildlife Code that relates to the use of animals in research. - Experience as a facilitator with research staff, faculty and students in evaluating needs of users, trainers, and materials available. - Knowledge of laws, regulations, guidelines, and policies dealing with the humane care and use of animals in research and teaching, including the Federal Animal Welfare Act, the US Public Health Service Policy on the Humane Use of Laboratory Animals, the NRC ILAR Guide, and the requirements of the California Fish & Wildlife Code as this code relates to the use of animals in research. - Skills to communicate clearly and concisely both orally and in writing. Skills to use computer applications such as word processing, spreadsheet, databases, and presentation programs. Preferred Qualifications - Certification (ALAT, LAT or LATG) by the American Association for Laboratory Animal Science (AALAS). Certified as a Professional IACUC Administrator (CPIA). Registration by the State of California as a Veterinary Technician (RVT). - Experience working in an IACUC office. Experience working with a wide variety of animals including traditional and nontraditional laboratory animals. - Experience in conducting and coordinating audits, investigations and evaluations and taking corrective action in a timely manner. - Experience as a facilitator with departmental staff, faculty and students in evaluating needs of users, trainers, and materials available. Key Responsibilities - 40% - IACUC Inspections - 30% - Training and /or ATS Oversight and/or Web Page Document Upkeep and/or IACUC OFFICE General Function Support. Liasson with Regulatory and Accrediting Agencies/ Departmental Workgroups and Teams; IACUC On-Call and Other Duties as Assigned - 30% - Review of Research Proposals Department Overview The UC Davis Institutional Animal Care and Use Committee (IACUC) Administration Office is a service and compliance department within the Office of Research that supports the faculty based Administrative Advisory Committee overseeing the use of animals in research and teaching on the Davis campus and remote sites. The IACUC Administration Office is the compliance arm of the UC Davis AAALAC, Int. accredited animal care and use program; one of the largest research and teaching programs in the United States. The IACUC operates under federal and state mandates and in accordance with UCOP policy. This position will be one of four Research Compliance Analyst 3 (RCA3) positions within the IACUC Office of 10 FTE (currently staffed at 9 FTE). Department Specific Job Scope The UC Davis Institutional Animal Care and Use Committee (IACUC) Administration Office is a service and compliance department within the Office of Research that supports the faculty based Administrative Advisory Committee overseeing the use of animals in research and teaching on the Davis campus and remote sites. The IACUC Administration Office is the compliance arm of the UC Davis AAALAC, Int. accredited animal care and use program; one of the largest research and teaching programs in the United States. The IACUC operates under federal and state mandates and in accordance with UCOP policy. This position will be one of four Research Compliance Analyst 3 (RCA3) positions within the IACUC Office of 10 FTE (currently staffed at 9 FTE). This is a hybrid position. The majority of work can be completed remotely. The position may require travel to Davis for periodic in-person events, committee meetings, and/or training. POSITION INFORMATION - Salary or Pay Range: $77,100.00/yr. -$139,900.00/yr. - Salary Frequency: Annual - Salary Grade: STEPS - UC Job Title: RSCH CMPLNC ANL 3 RP - UC Job Code: 005269 - Number of Positions: 1 - Appointment Type: Staff: Career - Percentage of Time: 100% - Shift (Work Schedule): M-F 8 AM-5 PM - Location: Davis, CA - Union Representation: RP - Research and Public Service Professionals - Benefits Eligible: Yes - This position is hybrid (mix of on-site and remote work) Benefits Outstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting either our handy Benefits Summary for UC Davis Health Employees or Benefits Summary for UC Davis Employees and our Benefits Page. If you are represented by a union, benefits are negotiated between the University of California (UC) and your union and finalized in a contract. Read your bargaining unit's employment contract, stay abreast of current negotiations and learn about collective bargaining at UC: https://ucnet.universityofcalifornia.edu/labor/bargaining-units/index.html - High quality and low-cost medical plans to choose from to fit your family's needs - UC pays for Dental and Vision insurance premiums for you and your family - Extensive leave benefits including Pregnancy and Parental Leave, Family & Medical Leave - Paid Holidays annually as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement - Paid Time Off/Vacation/Sick Time as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement - Continuing Education (CE) allowance and Education Reimbursement Program as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement - Access to free professional development courses and learning opportunities for personal and professional growth - WorkLife and Wellness programs and resources - On-site Employee Assistance Program including access to free mental health services - Supplemental insurance offered including additional life, short/long term disability, pet insurance and legal coverage - Public Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified roles - Retirement benefit options for eligible roles including Pension and other Retirement Saving Plans. More information on our retirement benefits can be found here Physical Demands - Standing - Frequent 3 to 6 Hours - Walking - Frequent 3 to 6 Hours - Sitting - Frequent 3 to 6 Hours - Lifting/Carrying 0-25 Lbs - Occasional Up to 3 Hours - Lifting/Carrying 26-50 lbs - Occasional Up to 3 Hours - Lifting/Carrying over 50 lbs - Never 0 Hours - Pushing/Pulling 0-25 Lbs - Occasional Up to 3 Hours - Pushing/Pulling 26-50 lbs - Occasional Up to 3 Hours - Pushing/Pulling over 50 lbs - Occasional Up to 3 Hours - Bending/Stooping - Occasional Up to 3 Hours - Squatting/Kneeling - Occasional Up to 3 Hours - Twisting - Occasional Up to 3 Hours - Climbing (e.g., stairs or ladders) - Occasional Up to 3 Hours - Reaching overhead - Occasional Up to 3 Hours - Keyboard use/repetitive motion - Continuous 6 to 8+ Hours Environmental Demands - Chemicals, dust, gases, or fumes - Never 0 Hours - Loud noise levels - Occasional Up to 3 Hours - Marked changes in humidity or temperature - Occasional Up to 3 Hours - Microwave/Radiation - Never 0 Hours - Operating motor vehicles and/or equipment - Frequent 3 to 6 Hours - Extreme Temperatures - Occasional Up to 3 Hours - Uneven Surfaces or Elevations - Occasional Up to 3 Hours Mental Demands - Sustained attention and concentration - Continuous 6 to 8+ Hours - Complex problem solving/reasoning - Continuous 6 to 8+ Hours - Ability to organize & prioritize - Continuous 6 to 8+ Hours - Communication skills - Continuous 6 to 8+ Hours - Numerical skills - Frequent 3 to 6 Hours - Constant Interaction - Frequent 3 to 6 Hours - Customer/Patient Contact - Never 0 Hours - Multiple Concurrent Tasks - Continuous 6 to 8+ Hours Work Environment UC Davis is a smoke and tobacco free campus effective January 1, 2014. Smoking, the use of smokeless tobacco products, and the use of unregulated nicotine products (e-cigarettes) will be strictly prohibited on any UC Davis owned or leased property, indoors and outdoors, including parking lots and residential space. Valid CA driver's license required. Work occasional flexible schedule including evenings, weekends and holidays to meet operational needs. Occasional overnight travel. Employee is personally responsible for following health and safety guidelines/instructions. Work with, or be in areas, where hazardous materials and/or infectious diseases are present. This position is subject to Medical Surveillance procedures and review in accordance with Federal and State Laws, Regulations, and University Policy. Employee shall participate in required preventative medical and medical monitoring programs which may include blood tests, immunizations, TB screening, blood-borne and airborne pathogen training, etc., as required to meet Federal, State and University requirements. Wear protective clothing and respirator in circumstances that require personal protection from infectious disease. Special Requirements – Please contact your recruiter with questions regarding which activities apply by position - This is a critical position, as defined by UC Policy and local procedures, and as such, employment is contingent upon clearing a criminal background check(s) and may include drug screening, medical evaluation clearance and functional capacity assessment Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. A Culture of Opportunity and Belonging At UC Davis, we’re committed to solving life’s most urgent challenges and building a healthier, more resilient world. We believe in growing through every challenge, continually striving to improve, and welcoming new perspectives that strengthen our community. We recognize that a vibrant and innovative organization values both individual strengths and shared purpose. The best ideas often emerge when people with different experiences come together. As you consider joining UC Davis, we invite you to explore our Principles of Community, our Clinical Strategic Plan and strategic vision for research and education. We believe you belong here. The University of California, Davis is an Equal Opportunity Employer. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status. To view the University of California’s Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination Because we want you to feel seen and valued, our recruitment process at UC Davis supports openness and authenticity. Research shows that some individuals hesitate to apply unless they meet every qualification. You may be an excellent fit for this role-or the next one. We encourage you to apply even if your experience doesn't match every listed requirement. #YouBelongHere To learn more about our background check program, please visit: https://hr.ucdavis.edu/departments/recruitment/ucd/selection/background-checks

California
$77.1K - $139.9K / year
State of North Carolina logo

Associate Director, Provider Compliance

State of North Carolina

The State of North Carolina is a southeastern state with 100 counties and is the ninth most populous state in the U.S. North Carolina's moderate climate, rich c

Compliance2 days ago

Title: Associate Director, Provider Compliance Location: Wake County United States Ful time Hybrid The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence. Description of Work The NC Medicaid Office of Compliance and Program Integrity (OCPI) monitors the Medicaid community (beneficiaries, providers, vendors and internal staff) for compliance with state and federal regulations and potential fraud, abuse and neglect. OCPI verifies dollars are paid appropriately for covered services by using claim reviews and investigations, implementing recoveries, pursuing recoupments and aggressively identifying other opportunities for cost avoidance. The Associate Director, Provider Compliance is a senior management position responsible for assisting the Deputy Director/Chief Compliance Officer in key activities of DHB's Office of Compliance and Program Integrity unit. This position will be responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State's contracted health plans while developing and implementing procedures for conducting provider audits and investigations in accordance with all federal and state rules and regulations to reduce provider fraud, waste and abuse. This position will ensure NC Medicaid managed care organizations have and follow sound principles and practices for conducting provider audits, investigations and monitoring. This role will work in partnership with DHB Provider Operations and DHB Clinical Policy to facilitate the adequate implementation of provider policies and practices which lead to compliance with Centers for Medicare & Medicaid Services (CMS) rules and guidelines and North Carolina legislative requirements for Medicaid providers. Job Specific Responsibilities: - Lead the development, maintenance and execution of documented policies and procedures for the establishment of OCPI's provider audits and investigations protocol to prevent illegal, unethical, or improper payment of Medicaid dollars. - Lead the development, maintenance and execution of documented policies and procedures for NC Medicaid's approach to effective oversight and monitoring of the State's contracted Managed Care Plans' Special Investigations Units. - Oversee the scope of work development and execution of vendors conducting provider audits and investigations under OCPI responsibility and liaise with other business unit leaders for joint provider audit and investigations efforts. - Enforce provider policies and procedures to include the use of standardized investigations and corrective actions to address identified and reported violations. - Ensure that the processes and procedures are aligned with authorized enforcement authorities. - Develop and perform and/or authorize periodic provider audit initiatives to ensure that compliance with clinical and payment policies is being achieved and that the compliance program is relevant and up to date with the needs and requirements of DHB and CMS. - Successfully liaise and collaborate with OCPI Compliance Analytics, Medicaid Investigations Division (MID), legal counsel (e.g., DHB Attorney, etc.) and others as necessary for expert consultation, clarification and/or approval of provider compliance-based initiatives and interests, to include escalation of high-priority concerns or violations and prosecutions. - Measure and report on operational performance and lead the development of plans to improve relevant key performance indicators within the Provider Compliance unit. - Engage in personnel administration to include but not limited to recruiting, selecting, and managing employees; delegating to staff members; encouraging and fostering professional development; establishing effective professional goals and work plan objectives. Knowledge Skills and Abilities/Management Preferences Recruitment Range $100,641 - $107,816 Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement. The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred: - Deep expertise in detecting and preventing fraud, waste, and abuse (FWA) within Medicaid and managed care, supported by the ability to translate data insights into actionable investigative strategies. - Proven ability to lead complex investigations, analyze evidence, prepare cases for referral, and support criminal or civil proceedings while ensuring compliance with state and federal regulations. - Demonstrated leadership experience managing large teams, overseeing vendor relationships, and fostering collaboration across internal and external stakeholders. - Skilled in building and maintaining effective partnerships with law enforcement, prosecutorial agencies, providers, and health plans, supported by exceptional written and verbal communication for reports, presentations, and negotiations. - Strong proficiency in Microsoft Office applications (Teams, Outlook, Excel, Word) with the ability to coach staff, manage performance, and coordinate high‑impact investigative and program activities. Management Preferences: - Previous work experience with a Medicaid agency. - Experience effectively managing personnel in the execution of provider audits and investigations. - Considerable knowledge of healthcare operations. - Familiarity with state of NC contracting processes, including vendor monitoring. The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries. Compensation & Benefits: The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees.

North Carolina
$100.6K - $107.8K / year
Diebold Nixdorf logo

Senior Director, Chief Compliance Officer

Diebold Nixdorf

We automate, digitize, and transform the way people bank and shop.

Compliance2 days ago
Full TimeRemoteTeam 10,001+Since 1859H1B Sponsor

Role Description As Senior Director, Chief Compliance Officer, you will build, lead, and evolve a global compliance program that enables business growth while navigating increasingly complex regulatory environments across fintech, AI, global trade, and data privacy. You will operate as a trusted advisor to executive leadership and the Board, influencing decisions that directly impact the company’s strategy, risk posture, and long-term success. Qualifications - Experience in compliance programs across various sectors. - Strong leadership and advisory skills. - Ability to navigate complex regulatory environments. Requirements - Proven track record in compliance leadership. - Expertise in fintech, AI, global trade, and data privacy. - Strong communication and influencing skills. Benefits - Opportunity to work with diverse talents and expertise. - Engagement in business transformation and innovation. - Access to future technologies for personalized consumer experiences. Company Description The people of Diebold Nixdorf are 23,000+ teammates of diverse talents and expertise in more than 130 countries, harnessing future technologies to deliver personalized, secure consumer experiences that connect people to commerce. Our culture is fueled by our values of collaboration, decisiveness, urgency, willingness to change, and accountability. - Diebold Nixdorf is an equal opportunity employer. - We value diversity and do not discriminate based on various factors.

United States
$205K - $285K / year