Supervisor, Compliance

Position summary:

The Supervisor, Compliance leads the team responsible for third-party administration (TPA) claims compliance, fiduciary controls and financial reconciliations, regulatory reporting, vendor management, and staff development. This position oversees compliance operations, including reporting accuracy, error remediation, state forms governance, audit and reconciliation activities, and compliance-related initiatives, while ensuring adherence to statutory regulations and internal controls. The Supervisor partners collaboratively with Claims, Sales, Account Management, and other cross-functional business leaders to drive service excellence, operational efficiency, financial stewardship, and continuous improvement across the organization.

Responsibilities:

• Lead and manage compliance staff, assigning work, monitoring performance, and supporting professional development.
• Oversee EDI compliance, reporting, remediation efforts, and regulatory filing requirements to ensure jurisdictional compliance and minimize financial exposure.
• Direct compliance reporting, analytics, scorecards, and metrics to support operational performance and continuous improvement.
• Establish processes to identify, track, and mitigate penalties, compliance exceptions, errors and omissions, and other operational risks.
• Provide compliance expertise and system support to business partners, ensuring adherence to regulatory requirements, internal controls, and best practices.
• Oversee claims-related forms, regulatory documentation, compliance training materials, reference resources, and SharePoint content.
• Manage fiduciary controls, financial reconciliations, quality assurance audits, and invoicing processes to support financial accuracy and audit readiness.
• Lead vendor management activities, including onboarding, performance monitoring, audits, service level evaluations, stewardship meetings, and exception management.
• Partner with Claims, Sales, Account Management, and other stakeholders to support business objectives, service excellence, and operational effectiveness.
• Participate in and lead compliance-related projects, enterprise initiatives, system enhancements, and geographic expansion efforts.
• Develop and implement policies, procedures, and process improvements that strengthen compliance, productivity, and organizational efficiency.
• Maintain expertise in applicable regulatory requirements, industry trends, and reporting obligations, including Medicare and Section 111 reporting.
• Communicate compliance guidance, business updates, and strategic initiatives to stakeholders and team members.
• Conduct hiring, onboarding, coaching, succession planning, performance management, and employee engagement activities.
• Promote a culture of compliance, collaboration, customer service, ethics, and continuous improvement across the organization.
• Ensure compliance with the Company's Code of Business Conduct and Ethics and all applicable policies, procedures, and regulations.

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• Bachelor’s degree in business administration, risk management, or related field (or equivalent experience) and/or 3-5 years of progressive work experience in a third-party claims administrator or insurance related industry required
• Minimum 2 years of leadership/supervisory experience required
• Insurance related professional designations (CPCU, ARM, AIC, etc.) desired
• Demonstrated knowledge and compliance with claims administration policies and procedures, state and federal laws, and statutory regulations required   
• Aptitude for claims related systems, technology platforms, data analytics, and metrics
• Strong skills in applying sound judgement, including the ability to problem solve, establish goals, and implement action plans
• Ability to work successfully in a matrixed environment, collaborate with others, consider the needs of affected groups, and build and leverage cross-functional and cross-organizational relationships to achieve business results
• Effective written and verbal communication, presentation, data analysis, audit, organizational, and follow-through skills
• Strong technical aptitude with expertise in Excel, SharePoint, and other business applications, coupled with the ability to quickly learn and apply new technologies to create reports, dashboards, manage data, automate processes and support operations.