Director, Government Programs Compliance and Regulatory

Ankura is a team of excellence founded on innovation and growth.

Ankura is seeking a Director to lead complex compliance and operational advisory engagements for health plans and other clients across Medicare Advantage, Medicaid managed care, and Affordable Care Act marketplace programs.

The Director will serve as a senior subject matter expert on Centers for Medicare & Medicaid Services requirements, state Medicaid agency requirements, marketplace regulations, and related health plan operational expectations. This individual will lead engagement teams, manage senior client relationships, and oversee the development of analyses and deliverables designed to withstand scrutiny from regulators, counsel, and other stakeholders.

The Director will also play an important role in the continued growth of the practice by identifying client needs, scoping new engagements, contributing to proposals and business development efforts, and collaborating with Managing Directors to expand the practice’s capabilities and market presence.

Responsibilities

Client Engagement and Delivery

• Lead complex compliance and operational advisory engagements involving Medicare Advantage, Medicaid managed care, and Affordable Care Act marketplace programs.
• Direct regulatory audits, program integrity reviews, compliance assessments, corrective action planning, and regulatory readiness engagements.
• Serve as a senior subject matter expert on CMS guidance, state Medicaid agency requirements, marketplace requirements, and their application to health plan operations.
• Translate complex regulatory and contractual requirements into practical strategies, recommendations, and operational solutions for clients.
• Develop engagement approaches, scopes, work plans, timelines, resource requirements, and deliverable strategies.
• Direct multiple engagement workstreams and ensure that work is completed accurately, efficiently, and within established timelines and budgets.
• Identify significant compliance, operational, and regulatory risks and provide informed, practical recommendations to address them.
• Oversee complex analyses of health plan data, policies, procedures, controls, regulatory submissions, operational documentation, and other supporting materials.
• Guide the development of audit findings, workpapers, reports, presentations, corrective action plans, and other client deliverables.
• Ensure that engagement documentation and final deliverables are clear, well-supported, and prepared to withstand review by regulators, counsel, and senior client stakeholders.
• Lead executive-level presentations and meetings, clearly communicating complex findings, risks, and recommendations.
• Proactively identify and mitigate engagement risks and escalate significant concerns when appropriate.

Business and Practice Development

• Support business development by identifying prospective client needs and developing tailored solutions.
• Lead or contribute to the scoping of new engagements, including defining objectives, deliverables, staffing requirements, timelines, and fee structures.
• Develop and contribute to proposals, statements of work, presentations, and other business development materials.
• Participate in meetings with prospective clients and clearly articulate Ankura’s capabilities, approach, and value proposition.
• Collaborate with Managing Directors and other practice leaders to develop and expand service offerings.
• Monitor regulatory developments, enforcement trends, and emerging industry issues to identify market needs and new opportunities.
• Contribute to thought leadership, industry presentations, articles, webinars, and other market-facing initiatives.
• Develop reusable tools, methodologies, templates, and intellectual capital that strengthen project delivery and support practice growth.
• Leverage industry relationships and professional networks to enhance Ankura’s presence in the marketplace.

Qualifications

• Bachelor’s degree from an accredited college or university.
• Significant relevant experience in health plan compliance, regulatory affairs, health plan operations, consulting, legal or regulatory advisory services, or a related field.
• Deep knowledge of Medicare Advantage, Medicaid managed care, Affordable Care Act marketplace programs, or other government-sponsored health care programs.
• Strong working knowledge of CMS guidance, state Medicaid agency requirements, marketplace regulations, and health plan contractual obligations.
• Experience leading regulatory audits, compliance assessments, program integrity reviews, corrective action planning, regulatory readiness activities, or similar engagements.
• Demonstrated ability to interpret complex regulatory requirements and evaluate their application to health plan operations.
• Experience leading complex consulting or advisory engagements, including responsibility for scope, work plans, staffing, budgets, timelines, quality, and client deliverables.
• Demonstrated experience managing senior client relationships and advising executive-level stakeholders.
• Strong analytical and critical-thinking capabilities, with the ability to synthesize complex or unstructured information and develop practical recommendations.
• Excellent written and verbal communication skills, including the ability to prepare and present clear, compelling, and defensible client deliverables.
• Demonstrated ability to lead, develop, and motivate engagement teams.
• Experience contributing to business development, proposal preparation, engagement scoping, or the development of new client opportunities.
• Ability to manage multiple priorities in a fast-paced, client-service environment.
• Proficiency in Microsoft Excel, Word, and PowerPoint.
• Ability and willingness to travel based on client and engagement needs.

Preferred Qualifications

• Advanced degree in health care administration, public health, business, law, public policy, or a related discipline.
• Relevant professional certification in health care compliance, auditing, project management, or a related area.
• Consulting or professional services experience serving health plans, government agencies, or health care organizations.
• Experience responding to regulatory inquiries, audits, enforcement matters, or corrective action requirements.
• Experience working with or advising compliance, legal, internal audit, government programs, and health plan operational functions.
• Established professional relationships within the health plan, regulatory, or health care compliance community.
• Experience developing new service offerings, methodologies, thought leadership, or intellectual capital.

Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. Equal Employment Opportunity Posters, if you have a disability and believe you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email or call toll-free +1.312-583-2122. This email and phone number are created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues unrelated to a disability, will not receive a response.

Originally posted on Himalayas