Compliance Specialist Principal (Eastern US resident)

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

Yes

Job Summary:

The Principal Compliance Specialist serves as the organization's subject matter authority for a defined regulatory domain or program area, independently managing complex and enterprise-scope matters from initiation through resolution without a defined playbook to follow. Operating across a large healthcare system, the Principal Specialist produces the analytical conclusions, regulatory interpretations, investigative findings, and policy recommendations that Directors and Executives rely on to make high-stakes compliance decisions. This role is the right fit for a seasoned compliance professional who wants to do the most intellectually demanding individual contributor work in the field, with direct visibility to senior leadership and enterprise-level impact, without moving into people management.

Job Duties:

• Independently manages a defined compliance program area from annual work plan development through execution, monitoring, reporting, and closure without requiring supervisory structuring of tasks or priorities.
• Analyzes complex and novel regulatory requirements, federal and state guidance documents, and enforcement trends; produces written regulatory impact analyses identifying the specific operational change required, the responsible business unit, and the recommended implementation timeline.
• Designs and executes monitoring and auditing activities for assigned program areas, including selection of review methodology, sample design, data collection, findings documentation, and written presentation of results to the Manager or Director.
• Leads compliance investigations assigned at the Principal level by coordinating information collection, conducting or managing interviews, documenting evidentiary findings, and producing a written investigative report that includes substantiation analysis and recommended corrective action for Director review.
• Develops, drafts, and revises compliance policies, standards, and procedures for review and approval by the Director or Associate Officer; ensures each policy accurately reflects current regulatory requirements and is written to be operationally executable by the functions it governs.
• Identifies compliance gaps through proactive program assessment; documents each gap with a risk severity rating using the function's established scoring methodology, a root cause analysis, and a recommended remediation plan with an assigned implementation owner.
• Manages cross-functional compliance projects by developing the project work plan, assigning tasks to participating staff, tracking progress against established milestones, and escalating risks or delays to the Manager or Director with a documented options analysis.
• Prepares written materials, including regulatory analysis memos, program status reports, and executive summary decks that communicate findings and recommendations to Director and VP-level leadership in a form suitable for executive review without additional editing.
• Contributes to the annual enterprise compliance risk assessment by identifying and documenting risks within the assigned program area, scoring each risk using the function's established severity and likelihood methodology, and submitting a completed risk register section to the Director by the designated deadline.
• Monitors published regulatory guidance, enforcement actions, and material industry developments relevant to the assigned domain on an ongoing basis; produces a written impact summary identifying the operational effect and recommended organizational response within 30 days of material issuance.
• Serves as the primary compliance point of contact for assigned operational business partners; manages the relationship by conducting regular touchpoints, communicating program requirements, and tracking open compliance commitments to closure.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details:

Preferred Qualifications:

• Experience in an integrated delivery network (IDN) operating across both provider and payer environments simultaneously.
• Experience presenting compliance, or risk, findings directly to Director or Associate Officer-level leadership.
• Advanced degree (JD, MPH, MBA, MHA, or MS in a relevant field) or an active advanced professional certification (CHC, CHPC, CHRC, CIPP/US, or equivalent).

Skills & Competencies:

• Demonstrated ability to read, interpret, and apply federal and state healthcare regulatory requirements to organizational operations independently, including identifying operational impact and formulating a recommended response without supervisory direction.
• Demonstrated ability to manage multiple concurrent work streams to established deadlines without supervisory structuring of priorities.
• Demonstrated ability to communicate complex regulatory or risk findings in writing to non-specialist audiences, including business operations leaders and executive staff, in a form requiring no technical translation by the recipient.
• Demonstrated ability to conduct or lead investigations, including evidence collection, interview management, and production of a written substantiation analysis sufficient for legal review.

Education:

Bachelor's Degree-Related Field of Study (Required), Juris Doctor- (Preferred)

Experience:

Minimum of 8 years-Related work experience (Required)

Certification(s) and License(s):

Skills:

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
• INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Originally posted on Himalayas