Manager, Claims Compliance

Job Summary

The Manager, Claims Compliance is responsible for ensuring Core Administrative Operations meet federal, state, and contractual regulatory requirements. This position oversees regulatory interpretation, operational compliance monitoring, corrective action oversight, and the development and delivery of operational training across all claims-related functions. The Manager establishes and maintains documentation standards, partners with operational leaders to evaluate compliance risk, and develops training and readiness programs that ensure staff consistently understand rules, follow procedures, and meet regulatory expectations.

The Manager serves as the primary compliance liaison for Core Administrative Operations, ensuring that regulatory requirements are embedded into workflows, policies, and training. This position partners closely with the key stakeholders to ensure alignment between compliance oversight, audit findings, training programs, cor...