Assist Manager Compliance

<div><div><div><div><div><div><div><div><div><div><div><div><div><div><p style="text-align:left"><span>Sagility combines industry-leading technology and <span><span><span><span><span><span><span class="WHI1"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">transformation-driven</span></span></span></span></span></span></span></span> BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.</span></p></div></div></div></div></div></div></div></div></div></div></div></div></div></div>Core Responsibilities – Exclusion Screening<br>• Operate enterprise screening for employees, contractors, and vendors.<br>• Perform checks against OIG LEIE, SAM.gov, State Medicaid exclusions, and OFAC/sanctions.<br>• Use screening platforms (Certiphi, LexisNexis, Refinitiv, Exiger or equivalent) to adjudicate hits and document decisions.<br>• Escalate confirmed/high-risk matches to Legal, HR, Compliance, and Operations.<br>• Manage periodic re-screening cycles and maintain audit-ready evidence.<br>Core Responsibilities – Vendor Compliance / TPRM<br>• Support onboarding due diligence, ongoing monitoring, and re-certifications.<br>• Track and validate vendor compliance artifacts and attestations.<br>• Partner with Procurement, Legal, InfoSec, and Business Owners to remediate gaps.<br>• Maintain records and evidence in AuditBoard or designated GRC systems.<br>Core Responsibilities – CMS Audit Support<br>• Serve as a primary contributor for CMS audits and related state/payer audits.<br>• Prepare and maintain audit-ready documentation (policies, SOPs, control narratives, evidence).<br>• Coordinate audit requests, walkthroughs, and evidence submissions using AuditBoard.<br>• Track audit findings and manage CAPs to closure with evidence.<br>• Participate in mock audits and readiness reviews.<br>Compliance Operations, GRC & Reporting<br>• Use AuditBoard to manage Incidents, Issues, Actions (CAPs), Evidence, and Dashboards.<br>• Produce management and governance reporting on screening, vendor compliance, and audits.<br>• Draft and maintain SOPs, job aids, and process documentation.<br>Issue Management & Remediation<br>• Log and manage issues related to screening, vendor compliance, and audit findings.<br>• Drive CAPs to on-time closure and validate effectiveness.<br>• Escalate high-risk or overdue issues appropriately.<br>Training & Stakeholder Advisory<br>• Guide HR, Procurement, Operations, and Business Leaders on screening and vendor compliance.<br>• Support training on CMS audit expectations and evidence standards.<br>Tools & Systems<br>• AuditBoard (or equivalent GRC)<br>• Screening platforms: Certiphi, LexisNexis, Refinitiv, Exiger (or equivalent)<br>• OIG LEIE, SAM.gov, State Medicaid lists, OFAC<br>• Excel/BI and workflow/case management tools<br>Qualifications & Experience<br>• Bachelor’s degree (or equivalent experience).<br>• 5+ years in healthcare compliance, exclusion screening, vendor compliance, or audit support.<br>• Demonstrated experience supporting CMS audits, state audits, or payer audits.<br>• Strong knowledge of OIG/CMS expectations and audit evidence standards.<br>• Experience with AuditBoard or similar GRC tools preferred.<br>Key Competencies<br>• CMS audit and healthcare regulatory acumen<br>• Risk and control mindset<br>• Audit and evidence rigor<br>• Process improvement and automation mindset<br>• Stakeholder management and communication<br>Performance Metrics (KPIs)<br>• % populations screened on time<br>• Hit adjudication turnaround time<br>• Vendor compliance completion rate<br>• CMS audit findings count and severity<br>• CAP on-time closure rate<br>• Evidence completeness and audit re-use rate<br>Internal Leveling Alignment<br>• Compliance Analyst (C2): Executes screenings and supports audits<br>• Senior Compliance Analyst (C3 – this role): Owns operations and leads CMS audit support<br>• Lead/Principal (C4): Designs program and leads domain audits<br>• Manager (M1): Owns outcomes, staffing, executive and board reporting<div><div><div><div><div><div><div><p></p><p><b>Job title:</b></p></div></div></div></div></div></div></div>Assist Manager Compliance<div><div><div><div><div><div><div><p style="text-align:inherit"></p><p style="text-align:left"><b>Job Description:</b></p></div></div></div></div></div></div></div><h1>Core Responsibilities – Exclusion Screening</h1><p>• Operate enterprise screening for employees, contractors, and vendors.<br>• Perform checks against OIG LEIE, SAM.gov, State Medicaid exclusions, and OFAC/sanctions.<br>• Use screening platforms (Certiphi, LexisNexis, Refinitiv, Exiger or equivalent) to adjudicate hits and document decisions.<br>• Escalate confirmed/high-risk matches to Legal, HR, Compliance, and Operations.<br>• Manage periodic re-screening cycles and maintain audit-ready evidence.</p><h1>Core Responsibilities – Vendor Compliance / TPRM</h1><p>• Support onboarding due diligence, ongoing monitoring, and re-certifications.<br>• Track and validate vendor compliance artifacts and attestations.<br>• Partner with Procurement, Legal, InfoSec, and Business Owners to remediate gaps.<br>• Maintain records and evidence in AuditBoard or designated GRC systems.</p><h1>Core Responsibilities – CMS Audit Support</h1><p>• Serve as a primary contributor for CMS audits and related state/payer audits.<br>• Prepare and maintain audit-ready documentation (policies, SOPs, control narratives, evidence).<br>• Coordinate audit requests, walkthroughs, and evidence submissions using AuditBoard.<br>• Track audit findings and manage CAPs to closure with evidence.<br>• Participate in mock audits and readiness reviews.</p><h1>Compliance Operations, GRC & Reporting</h1><p>• Use AuditBoard to manage Incidents, Issues, Actions (CAPs), Evidence, and Dashboards.<br>• Produce management and governance reporting on screening, vendor compliance, and audits.<br>• Draft and maintain SOPs, job aids, and process documentation.</p><h1>Issue Management & Remediation</h1><p>• Log and manage issues related to screening, vendor compliance, and audit findings.<br>• Drive CAPs to on-time closure and validate effectiveness.<br>• Escalate high-risk or overdue issues appropriately.</p><h1>Training & Stakeholder Advisory</h1><p>• Guide HR, Procurement, Operations, and Business Leaders on screening and vendor compliance.<br>• Support training on CMS audit expectations and evidence standards.</p><h1>Tools & Systems</h1><p>• AuditBoard (or equivalent GRC)<br>• Screening platforms: Certiphi, LexisNexis, Refinitiv, Exiger (or equivalent)<br>• OIG LEIE, SAM.gov, State Medicaid lists, OFAC<br>• Excel/BI and workflow/case management tools</p><h1>Qualifications & Experience</h1><p>• Bachelor’s degree (or equivalent experience).<br>• 5+ years in healthcare compliance, exclusion screening, vendor compliance, or audit support.<br>• Demonstrated experience supporting CMS audits, state audits, or payer audits.<br>• Strong knowledge of OIG/CMS expectations and audit evidence standards.<br>• Experience with AuditBoard or similar GRC tools preferred.</p><h1>Key Competencies</h1><p>• CMS audit and healthcare regulatory acumen<br>• Risk and control mindset<br>• Audit and evidence rigor<br>• Process improvement and automation mindset<br>• Stakeholder management and communication</p><h1>Performance Metrics (KPIs)</h1><p>• % populations screened on time<br>• Hit adjudication turnaround time<br>• Vendor compliance completion rate<br>• CMS audit findings count and severity<br>• CAP on-time closure rate<br>• Evidence completeness and audit re-use rate</p><h1>Internal Leveling Alignment</h1><p>• Compliance Analyst (C2): Executes screenings and supports audits<br>• Senior Compliance Analyst (C3 – this role): Owns operations and leads CMS audit support<br>• Lead/Principal (C4): Designs program and leads domain audits<br>• Manager (M1): Owns outcomes, staffing, executive and board reporting</p><div><div><div><div><div><div><div><p style="text-align:inherit"></p><p style="text-align:left"><b>Location:</b></p></div></div></div></div></div></div></div>Work@Home NationWideUnited States of America