Johns Hopkins Health Plans · 15 hours ago
Program Director - Compliance
DC-Baltimore Area
Contract
Onsite
Lead/Staff, Director/Executive
$104K/yr - $181K/yr
5+ years expJohns Hopkins Health Plans is seeking a driven Program Director - Compliance to lead their Medicare compliance program and ensure adherence to CMS and regulatory requirements. The role involves overseeing daily program operations, guiding compliance strategy, managing staff, and promoting a strong culture of compliance across the organization.
Health CarePersonal HealthWellness
Responsibilities
Lead the Medicare compliance program and ensure full adherence to CMS and regulatory requirements
Oversee daily program operations and guide compliance strategy and structure
Manage staff and partner across the organization and with FDRs to promote a strong culture of compliance
Drive auditing and monitoring efforts and lead key committees
Liaise with regulatory agencies and oversee corrective action and implementation of new guidance to maintain an effective, proactive compliance program
Qualification
Required
Bachelor's degree in Health Management, Business or other applicable concentration
A minimum of 5-7 years in a Medicare Compliance program and 3-5 years of management and supervisory experience
Knowledge of CMS Medicare Advantage and Part D contractual and regulatory requirements
Expert level knowledge of HIPAA requirements, 42 CFR 422, 42 CFR 423, Inflation Reduction Act, OIG Compliance Guidelines, and other key regulations related to public health
Strong critical thinking, strategic problem‑solving, and the ability to communicate complex compliance requirements clearly
Excel in interpersonal communication, customer service, and collaboration across all organizational levels
Strong analytical ability, data interpretation skills, and project management capabilities—including planning, implementation, and reporting
Proficiency with Microsoft Office applications and statistical audit tools
Ability to research regulations, manage multiple priorities, and meet tight deadlines with minimal supervision
Preferred
Master's degree or Juris Doctorate
Certification in Health Care Compliance, Fraud Examination or Internal Audit
Understanding of Maryland payment methodology and Health Services Cost Review Commission
Benefits
Tuition assistance
Dependent college tuition program
403(b) retirement savings
Health, dental vision and prescription coverage
Disability and life insurance
Paid time off
Holidays
Company
Johns Hopkins Health Plans
Johns Hopkins Health Plans provides excellent service and is dedicated to the health, life, and future.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
James Holland
President and CEO
Recent News
Johns Hopkins Health Plans
2025-11-20
Johns Hopkins Health Plans
2025-11-19
2025-09-12
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