Vice President of Compliance, Mass General Brigham Health Plan

Mass General Brigham•Somerville, MA

8d•$250,000 - $300,000•Hybrid

About The Position

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Responsible for the strategic leadership, design, and oversight of the organization’s enterprise compliance program across all lines of business, including Commercial, Medicaid, Medicare Advantage, and Dual Eligible Special Needs Plans (DSNP). Ensures the organization maintains full compliance with all applicable federal and state regulatory requirements while fostering a culture of ethics, integrity, and accountability. This role provides executive leadership for compliance governance, risk mitigation, auditing and monitoring, and regulatory engagement, and partners closely with senior leadership and the Board of Directors to ensure proactive identification and management of compliance risks.

Requirements

Bachelor’s degree in Healthcare Administration, Public Health Law, Business or related field required or the equivalent combination of training and experience, plus 12+ years of related experience.
12+ years of progressive experience in healthcare compliance, regulatory affairs, or risk management
7+ years of leadership experience in a complex, multi-line healthcare organization or health plan
Deep expertise across government programs (Medicare Advantage, Medicaid, DSNP) and commercial products
Experience interacting with regulatory agencies and leading audits and investigations

Nice To Haves

Master’s degree or JD strongly preferred.

Responsibilities

Develop and lead a comprehensive, enterprise-wide compliance program aligned with regulatory requirements and business strategy.
Establish and maintain compliance governance structures, including executive-level committees and Board of Directors reporting.
Ensure integration of compliance across all lines of business (Commercial, Medicaid, Medicare Advantage, DSNP).
Drive continuous improvement of the compliance framework in response to regulatory changes and organizational priorities.
Provide oversight of compliance with federal and state healthcare regulations, including CMS, Medicaid, and commercial requirements.
Lead enterprise risk assessment processes to identify, prioritize, and mitigate compliance risks.
Ensure alignment with accreditation standards and regulatory expectations across all products.
Stay current on regulatory changes and proactively guide operational leadership on implications.
Oversee enterprise compliance auditing and monitoring activities, including vendor and FDR oversight where applicable.
Ensure implementation of corrective action plans and validation of remediation effectiveness.
Lead or oversee investigations into potential compliance violations, coordinating with Legal as appropriate.
Ensure reporting mechanisms (e.g., hotline, internal reporting) are effective and trusted.
Establish and maintain enterprise compliance policies and standards.
Lead development and execution of compliance education and training programs across all employee populations.
Partner with Learning & Development on training program training creation and delivery.
Promote a culture of compliance, ethics, and accountability across the organization.
Ensure leaders are equipped to operationalize compliance requirements within their functions.
Serve as a trusted advisor to executive leadership on compliance and regulatory matters.
Present compliance program performance, risks, and key issues to executive leadership and the Board of Directors.
Act as primary liaison with regulatory agencies during audits, reviews, and investigations.
Partner cross-functionally with Legal, Operations, Clinical, Finance, and HR to ensure compliance integration.
Build, lead, and develop a high-performing compliance organization, including regulatory, Medicare/Medicaid compliance, and audit functions.
Establish clear goals, performance expectations, and talent development strategies.
Foster an inclusive, high-accountability culture aligned with organizational values.
Hold self and others accountable to meet commitments.
Focuses on collaboration and connection to contribute to a high performing workplace.
Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
Other duties as assigned with or without accommodation.