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CX Business Compliance Liaison

Role overview

Qualifications

  • Bachelor's degree or equivalent experience
  • Nine or more years of experience in healthcare operations, compliance, or related area
  • Experience working in a HIPAA-regulated environment
  • Proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint

Responsibilities

  • Monitor adherence to approved requirements and provide compliance guidance
  • Provide functional oversight for Verification Specialists and Senior Verification Specialists
  • Coordinate cross-functional issues with Privacy, Security, Legal, and other teams
  • Draft and maintain policies, SOPs, and other controlled documentation

Key facts

  • Remote from: United States
  • Full time
  • Senior (5-10 years)
  • $85K – $121K / year
  • English

Hard skills

Other skills

  • Quality Control
  • Microsoft Excel
  • Microsoft Word
  • Microsoft PowerPoint
  • Collaboration
  • Problem Solving
  • Communication

About the company

Gainwell Technologies LLC logo

Gainwell Technologies LLC

  • GovTech
  • Large
  • 10,001+
For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus. Built across more than five decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet agencies, health plans and MCOs where they are on their modernization journeys and propel them into the future of public health. Our commitment to innovation, deep experience and ability to leverage insights from customers across 50 states has allowed us to expand on next-generation, cloud-enabled technologies. Today, Gainwell offers one of the most comprehensive suites of scalable services and solutions on the market — all proven to deliver cost savings, better patient outcomes and an improved provider experience. Equally important to our expanding technologies and results: We bring ideas that bring policies to life.

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Job description

 

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

As a CX Business Compliance Liaison at Gainwell Technologies, you will support the Director of CX Business Compliance in translating approved requirements into consistent, evidence-based practices across Customer Experience accounts. You will provide day-to-day compliance oversight, consultative guidance, escalation coordination, reporting, and implementation support for member and provider account access, provider Electronic Funds Transfer (EFT), and portal administrator changes. You will provide functional oversight of verification-review activities performed by both Verification Specialists and Senior Verification Specialists, including reviews of completed account work and independent quality reassessments. Working with account leaders and functional partners, you will help resolve control gaps, maintain procedures, coordinate training, support new-account readiness, and provide backup support to maintain operational continuity within documented delegated authority.

What you should expect in this role

  • Compliance monitoring and guidance: Monitor adherence to approved requirements, identify control gaps and recurring issues, provide compliance guidance, and escalate findings or matters requiring additional authority.
  • Verification and quality oversight: Provide functional oversight and guidance for Verification Specialists and Senior Verification Specialists. Coordinate reviews of account work and independent quality reassessments to confirm required controls, approvals, supporting evidence, and documented outcomes are in place. Support audit-the-auditor reviews, sampling, calibration, root-cause analysis, and corrective-action validation.
  • Verification safeguards and escalations: Monitor adherence to authentication, identity and representative authority validation, trusted contact sources, outbound verification, approved scripts, and recording requirements. Serve as an escalation contact for complex, disputed, incomplete, or high-risk matters, including potential fraud, privacy, or security concerns.
  • Cross-functional coordination: Partner with Privacy, Security, Legal, Risk and Compliance, Operations, Quality, Technology, Training, implementation teams, and account leadership to align requirements, resolve issues, and document decisions.
  • Quality and continuous improvement: Support quality monitoring and secret shopper programs, communicate findings, coordinate corrective actions, and track recurring issues through resolution. Use review findings, operational data, and stakeholder feedback to improve processes, tools, training, consistency, efficiency, and risk reduction.
  • Procedure governance: Draft and maintain policies, SOPs, scripts, checklists, and work aids. Coordinate stakeholder reviews and approvals, communicate changes, and ensure approved procedures are consistently implemented across accounts.
  • Training and readiness: Coordinate role-based training, knowledge checks, access requirements, refresher training, and production-readiness activities. Support new-account implementations by aligning procedures, controls, training, reporting, escalation paths, and required approvals.
  • Reporting and records: Gather and validate compliance data, report trends, risks, corrective-action status, and readiness gaps, and maintain secure and traceable records, evidence, and audit trails.
  • Operational continuity: Provide backup support as needed to maintain CX Business Compliance activities, document actions and handoffs, and escalate matters outside delegated authority.

What we're looking for

Basic qualifications

  • Bachelor's degree or an equivalent combination of education and relevant experience.
  • Nine or more years of experience in healthcare operations, compliance, privacy, quality assurance, risk management, or a related area.
  • Experience working in a HIPAA-regulated environment and applying privacy, confidentiality, and information-handling requirements.
  • Experience reviewing business processes, documentation, or operational practices to identify compliance gaps and ensure established requirements are being followed.
  • Experience writing, developing, and maintaining policies, procedures, SOPs, or other controlled documentation.
  • Experience translating regulatory, contractual, or company requirements into practical business processes and controls.
  • Project management experience, including coordinating initiatives, priorities, and issue resolution across multiple teams or business areas.
  • Experience analyzing findings, identifying trends or root causes, tracking corrective actions, and communicating risks and recommendations to business leaders.
  • Proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint.

Preferred qualifications

  • Bachelor's degree in business administration, healthcare administration, compliance, risk management, or a related field.
  • Experience in Medicaid, healthcare compliance, privacy, provider operations, or member operations.
  • Experience supporting compliance monitoring, quality reviews, audits, corrective-action programs, or process improvement initiatives across multiple accounts or business areas.
  • Experience supporting new implementations, operational readiness, policy or SOP governance, training, or leadership reporting.
  • Familiarity with CXone, Motif, or similar case management, interaction review, verification, or reporting tools.
  • Compliance, privacy, security, or project management certification, such as IAPP CIPP, CIPM, or CIPT; PMP; CISA; CISM; or a comparable certification.

What you should expect in this role

  • Remote anywhere in the US
  • Opportunity to travel up to 10%

Applications for this position will be accepted until 11/16/2026.

#LI-LM1

#LI-REMOTE

The pay range for this position is $84,800.00 - $121,100.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

 

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