Sr. Compliance Specialist - Care Management Programs

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Compliance Specialist - Care Management Programs based in United States.

This role sits at the intersection of healthcare compliance and clinical operations, ensuring care management and utilization management programs operate in full alignment with regulatory, accreditation, and licensing requirements. You will act as a key compliance partner to clinical and operational teams, helping translate complex frameworks such as CMS, NCQA, and URAC standards into practical, day-to-day operational guidance. The position plays a critical role in reducing organizational risk while enabling efficient, high-quality care delivery across multi-state programs. You will collaborate closely with product, operations, and corporate compliance teams to support audits, policy governance, and regulatory readiness. This is a highly cross-functional role requiring both analytical rigor and hands-on operational engagement in a fast-evolving healthcare environment.

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Compliance Specialist - Care Management Programs based in United States.

This role sits at the intersection of healthcare compliance and clinical operations, ensuring care management and utilization management programs operate in full alignment with regulatory, accreditation, and licensing requirements. You will act as a key compliance partner to clinical and operational teams, helping translate complex frameworks such as CMS, NCQA, and URAC standards into practical, day-to-day operational guidance. The position plays a critical role in reducing organizational risk while enabling efficient, high-quality care delivery across multi-state programs. You will collaborate closely with product, operations, and corporate compliance teams to support audits, policy governance, and regulatory readiness. This is a highly cross-functional role requiring both analytical rigor and hands-on operational engagement in a fast-evolving healthcare environment.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

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