Compliance Program Manager (Government-Managed Healthcare Regulations Experience Required)

Liberty Dental Plan is seeking an experienced Compliance Program Manager to oversee regulatory and contractual compliance across our commercial, Exchange, Medicaid, and Medicare lines of business. This role requires a deep understanding of government-managed healthcare regulations and the ability to collaborate cross-functionally to ensure adherence to compliance standards. The ideal candidate will have strong analytical skills, excellent communication abilities, and the discretion to handle sensitive matters.

Candidates located in the Eastern Time Zone are preferred.

Key Responsibilities

• Serve as a subject matter expert on regulatory and contractual requirements affecting Liberty’s business lines.
• Monitor, track, and maintain a repository of regulatory requirements, summarizing key updates for leadership.
• Collaborate with internal departments to implement new contract requirements.
• Research and advise on ad hoc compliance-related inquiries.
• Respond to client and regulatory audits, including managing corrective action plans.
• Review agreements, policies, and member-facing materials to ensure compliance.
• Oversee Liberty’s annual risk assessment, compliance workplan, and testing program.
• Analyze compliance findings, identify trends, and provide performance improvement recommendations.
• Develop and maintain compliance reporting tools, including dashboards and tracking summaries.
• Lead compliance-related initiatives and special projects, supporting process improvements.
• Ensure compliance training materials are updated and coordinate enterprise-wide training.
• Support the HIPAA compliance program, including incident management.
• Coordinate quarterly Compliance Committee meetings and prepare reports for the Board of Directors.
• Identify opportunities to strengthen Liberty’s culture of compliance.
• Manage findings from exclusion and preclusion screenings, ensuring timely investigation and appropriate action for employees, contractors, or vendors identified on federal and state exclusion lists (e.g., OIG LEIE, GSA SAM) in accordance with organizational policies and regulatory requirements. 

Education & Experience

• Education: Bachelor’s degree required, with relevant industry certifications or equivalent experience.

• Must have 5+ years of hands-on HIPAA privacy compliance experience with proven track record successfully implementing and managing HIPAA privacy programs.

• Experience: Minimum of 7 years in progressive regulatory compliance roles, preferably in government-managed or regulated healthcare.

Skills & Knowledge

• Strong critical thinking and problem-solving skills.
• Experience compiling, analyzing, and organizing regulatory data.
• Expertise in Microsoft Office (Excel, Word, PowerPoint, SharePoint).
• Intermediate to advanced Excel skills (pivot tables, charts, macros, external data connections preferred).
• Effective communication skills across all levels of the organization.