Assistant Manager Compliance

Sagility combines industry-leading technology and transformation-driven 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.

The Senior Compliance Analyst is the operational owner of Sagility’s healthcare Exclusion Screening and Vendor Compliance programs and a key contributor to CMS audit readiness and response. This role ensures employees, contractors, and vendors are screened against OIG LEIE, SAM.gov, State Medicaid exclusions, and OFAC/sanctions (as applicable), maintains audit-ready evidence in AuditBoard, and supports CMS audits, state audits, payer audits, and client reviews end-to-end.

Job title:

Assistant Manager Compliance

Job Description:

Core Responsibilities – Exclusion Screening

• Operate enterprise screening for employees, contractors, and vendors.
  • Perform checks against OIG LEIE, SAM.gov, State Medicaid exclusions, and OFAC/sanctions.
  • Use screening platforms (Certiphi, LexisNexis, Refinitiv, Exiger or equivalent) to adjudicate hits and document decisions.
  • Escalate confirmed/high-risk matches to Legal, HR, Compliance, and Operations.
  • Manage periodic re-screening cycles and maintain audit-ready evidence.

Core Responsibilities – Vendor Compliance / TPRM

• Support onboarding due diligence, ongoing monitoring, and re-certifications.
  • Track and validate vendor compliance artifacts and attestations.
  • Partner with Procurement, Legal, InfoSec, and Business Owners to remediate gaps.
  • Maintain records and evidence in AuditBoard or designated GRC systems.

Core Responsibilities – CMS Audit Support

• Serve as a primary contributor for CMS audits and related state/payer audits.
  • Prepare and maintain audit-ready documentation (policies, SOPs, control narratives, evidence).
  • Coordinate audit requests, walkthroughs, and evidence submissions using AuditBoard.
  • Track audit findings and manage CAPs to closure with evidence.
  • Participate in mock audits and readiness reviews.

Compliance Operations, GRC & Reporting

• Use AuditBoard to manage Incidents, Issues, Actions (CAPs), Evidence, and Dashboards.
  • Produce management and governance reporting on screening, vendor compliance, and audits.
  • Draft and maintain SOPs, job aids, and process documentation.

Issue Management & Remediation

• Log and manage issues related to screening, vendor compliance, and audit findings.
  • Drive CAPs to on-time closure and validate effectiveness.
  • Escalate high-risk or overdue issues appropriately.

Training & Stakeholder Advisory

• Guide HR, Procurement, Operations, and Business Leaders on screening and vendor compliance.
  • Support training on CMS audit expectations and evidence standards.

Tools & Systems

• AuditBoard (or equivalent GRC)

• Screening platforms: Certiphi, LexisNexis, Refinitiv, Exiger (or equivalent)
  • OIG LEIE, SAM.gov, State Medicaid lists, OFAC
  • Excel/BI and workflow/case management tools

Qualifications & Experience

• Bachelor’s degree (or equivalent experience).
  • 5+ years in healthcare compliance, exclusion screening, vendor compliance, or audit support.
  • Demonstrated experience supporting CMS audits, state audits, or payer audits.
  • Strong knowledge of OIG/CMS expectations and audit evidence standards.
  • Experience with AuditBoard or similar GRC tools preferred.

Key Competencies

• CMS audit and healthcare regulatory acumen

• Risk and control mindset

• Audit and evidence rigor

• Process improvement and automation mindset
  • Stakeholder management and communication

Performance Metrics (KPIs)

• % populations screened on time

• Hit adjudication turnaround time

• Vendor compliance completion rate

• CMS audit findings count and severity
  • CAP on-time closure rate
  • Evidence completeness and audit re-use rate

Internal Leveling Alignment

• Compliance Analyst (C2): Executes screenings and supports audits
  • Senior Compliance Analyst (C3 – this role): Owns operations and leads CMS audit support
  • Lead/Principal (C4): Designs program and leads domain audits
  • Manager (M1): Owns outcomes, staffing, executive and board reporting

Location:

Work@Home Arizona (Mountain Day Light Time)United States of America

Originally posted on Himalayas