CX Business Compliance Liaison

• 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.

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.