Vice President of Compliance, Mass General Brigham Health Plan

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Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary 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.

Qualifications Principle Responsibilities:

Enterprise Compliance Strategy & Program Leadership 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.

Regulatory Oversight & Risk Management 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.

Audit, Monitoring & Investigations 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.

Policies, Training & Culture Establish and maintain enterprise compliance policies and standards.

Lead…