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HealthEdge

Core administrative systems for health plans

Compliance Manager - Governance and Enablement

Regulatory Compliance & EthicsConfirmed live in the last 24 hours
Full-timeRemote in USA$100k - $115k /yr

About the Job

Requirements

  • A bachelor's degree in Business, Healthcare Administration, Compliance, Risk Management, Human Resources, Operations, or a related field, or equivalent work experience.
  • At least five years of experience in compliance, governance, risk management, operations, audit, quality, project management, or a related function.
  • Experience supporting compliance governance routines, issue tracking, documentation, reporting, or audit readiness activities.
  • Certification through an accredited compliance organization such as the Society for Corporate Compliance and Ethics (CCEP) or the Health Care Compliance Association (CHC).
  • Experience in healthcare, managed care, payer operations, shared services, HR operations, or regulated business environments.
  • Strong communication, organization, stakeholder management, and follow-through skills.
  • Demonstrated ability to manage multiple priorities, track deliverables, and meet deadlines.
  • Experience working cross-functionally with business, compliance, legal, audit, risk, or operational teams.
  • Ability to interpret compliance requirements and translate them into practical business processes.
  • Ability to manage governance routines, action logs, deliverables, and stakeholder follow-up.
  • Ability to build trusted relationships with business, compliance, legal, and operational stakeholders.
  • Ability to develop clear templates, process documentation, job aids, and reporting materials.
  • Ability to influence without direct authority and drive accountability across teams.
  • Ability to maintain confidentiality and handle sensitive information appropriately.
  • Working knowledge of regulatory and operational compliance governance, risk management, audit readiness, and internal controls.
  • Understanding of issue management, corrective action planning, remediation tracking, and root cause analysis.
  • Familiarity with compliance reporting, metrics, dashboards, and executive-level status updates.
  • Knowledge of change management and communication practices.
  • Proficiency with Microsoft Office tools, including Excel, PowerPoint, Word, Teams, and SharePoint.

Responsibilities

  • Manage governance forums, agendas, decision logs, action tracking, and related governance documentation, including policies, procedures, standards, control documentation, process maps, playbooks, training materials, and reporting templates.
  • Support execution of strategic departmental priorities from planning through implementation.
  • Monitor cross-functional dependencies and escalate risks to leadership.
  • Support the development, implementation, and ongoing management of compliance governance frameworks, routines, and operating practices.
  • Partner with business, compliance, legal, and operations teams to ensure compliance requirements are understood and embedded into business processes.
  • Coordinate departmental key performance indicators and executive dashboarding, and monitor departmental performance against strategic objectives.
  • Support critical compliance communication channels, including SharePoint, the hotline, and multiple email channels.
  • Identify opportunities to improve governance processes and operational efficiency.
  • Support development of standardized workflows, templates, and operating procedures by promoting consistency and continuous improvement across the Compliance and Privacy organization.
  • Collaborate with stakeholders to simplify and standardize compliance processes where possible.
  • Support change management and communication efforts related to new or changing compliance requirements.
  • Promote a culture of accountability, transparency, risk awareness, and compliance ownership.

Desired Qualifications

  • Familiarity with healthcare, claims, payer operations, HR, technology, or shared services compliance environments, depending on business area.
  • Familiarity with workflow, audit, risk, project management, or reporting tools such as Smartsheet, Jira, Power BI, or similar platforms.
  • Experience supporting client audits, regulatory reviews, internal audits, compliance assessments, or corrective action plans.
  • Experience developing governance materials, dashboards, executive summaries, training materials, or process documentation.
  • Knowledge of compliance frameworks, risk management practices, internal controls, and evidence management.
  • Project management, process improvement, compliance, audit, or risk-related certification.

About the Company

HealthEdge

Core administrative systems for health plans

HealthEdge provides software for healthcare payers, delivering core administrative systems and care-coordination tools for health plans. Its flagship HealthRules Payor uses business rules and workflows to automate claims processing, member services, and provider-network management, integrating with existing payer systems to streamline operations. The company differentiates itself with a 11-year Gartner Sample Vendor recognition, proven claims efficiency, and partnerships like CitiusTech, offering an end-to-end solution that covers licensing, implementation, and ongoing support. Its goal is to help health plans operate more efficiently, improve care coordination, and thrive under value-based reimbursement.

Company size
1,001-5,000
Company stage
Late Stage VC
Total funding
$97.8M
Headquarters
Burlington, MA
Founded
2004

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