Sr Manager - Corporate Compliance

Position Summary

***This position is to be filled within the state of Maryland

This role leads and manages the compliance program for Aetna's Maryland Medicaid health plan. The Compliance Officer ensures the health plan follows all state Medicaid regulations, contract requirements, and company policies. The position works closely with state agencies, internal business partners, and compliance team members to identify risks, manage audits, and promote ethical and compliant operations.

Key Responsibilities

• Serve as the Compliance Officer for Aetna's Maryland Medicaid health plan.
• Act as the primary contact with the Maryland Medicaid agency for compliance and contract-related matters.
• Track, monitor, and submit required regulatory reports and responses on time.
• Lead preparation and coordination for state audits, including corrective action plans and issue resolution.
• Manage all aspects of the Medicaid compliance program.
• Research regulatory requirements and provide recommendations to support compliant business practices.
• Draft and coordinate responses to inquiries and requests from state Medicaid agencies.
• Maintain expert knowledge of Medicaid regulations, contracts, and program requirements.
• Serve as a compliance resource for staff, providing guidance, education, and training.
• Maintain compliance tools, risk assessments, reporting systems, and tracking processes.
• Identify compliance risks, conduct monitoring activities, and recommend corrective actions.
• Support business teams in developing solutions to address compliance concerns.
• Utilize compliance management tools, including Microsoft Office and Archer.
• Build and maintain strong relationships with internal and external stakeholders.
• Provide guidance and coaching to less experienced team members.
• Perform other duties as assigned.

Required Qualifications

• 7+ years of compliance experience in healthcare, managed care, insurance, or a related field.
• Candidates with an advanced degree may qualify with 5+ years of relevant experience.
• Project management experience.

Preferred Qualifications

• Experience with Medicaid or Medicaid managed care programs.
• Experience supporting audits or regulatory reviews.
• Bachelor's degree in Public Policy, Government Affairs, Healthcare Administration, Public Administration, or a related field.
• Master's degree or Juris Doctor (JD).

Education

• Bachelor degree OR equivalent experience.