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
Apply To This Job
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
Apply To This Job