Manager, Government Program Compliance – Risk Adjustment

Health Care Service Corporation

Compliance Manager focused on Government Program regulations and overseeing operational compliance. Collaborating with multiple teams to manage risks and ensure adherence to laws for HCSC.

Posted 4/25/2026full-timeRemote • Illinois, New Mexico, Tennessee • 🇺🇸 United StatesMid-LevelSenior💰 $92,700 - $167,500 per yearWebsite

About the role

Key responsibilities & impact

Evaluate Government Program (Medicare and Medicaid) regulations, guidance and contracts.
Assess the risk these items present with respect to HCSC government contracts.
Manage direct reports and provide oversight of operational compliance.
Ensure adherence to federal/state/local laws, regulations, and contractual obligations.
Develop policies, conduct monitoring, manage risk, and liaise with regulatory agencies.
Identify risks and issues of noncompliance and develop mitigation strategies.
Collaborate with Corporate Compliance and business personnel, as well as HCSC management and governmental agencies to implement controls and processes.

Requirements

What you’ll need

Bachelor’s Degree and five (5) years’ experience in healthcare compliance OR nine (9) years’ experience in health plan, regulatory compliance or risk management.
One year of leadership/supervisory experience.
Experience communicating and building relationships with internal business units and/or various external governmental agencies.
Strong critical thinking, risk assessment, and mitigation abilities.
Ability to influence processes to achieve results.
Excellent verbal and written communication skills.
Ability to work independently and be a self-starter.
Organizational, project management, analytical and decision-making skills.
PC proficiency to include MS Teams, Word, PowerPoint and Excel as well as Workday.

Benefits

Comp & perks

health and wellness benefits
401(k) savings plan
pension plan
paid time off
paid parental leave
disability insurance
supplemental life insurance
employee assistance program
paid holidays
tuition reimbursement
annual incentive bonus plan

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

healthcare compliancerisk managementregulatory compliancepolicy developmentmonitoringrisk assessmentmitigation strategiesoperational compliance

Soft Skills

leadershipcommunicationcritical thinkingrelationship buildingorganizational skillsproject managementanalytical skillsdecision-makingself-starter