Compliance Program Consultant IV

Medica is a nonprofit health plan that serves communities across Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We are seeking a Compliance Program Manager to administer an assigned compliance program, providing subject‑matter expertise and consultation to ensure compliance with state and federal laws, regulations, and mandates. The role designs and incorporates processes and internal regulations to support compliance standards within the organization. Responsibilities Lead compliance review of materials across all lines of business, including member, provider, broker and public‑facing communications. Ensure materials adhere to applicable regulatory requirements, internal policies and established compliance standards. Interpret complex and evolving regulatory requirements and apply them consistently across materials. Serve as escalation point for complex, high‑risk or ambiguous materials determinations. Design and maintain materials review workflows and governance processes, including intake, review, approval and documentation standards. Develop and document standard operating procedures (SOPs) to support consistent and compliant materials review practices. Create and maintain job aids and training materials to support efficient and consistent execution of materials review processes by team members and business partners. Monitor materials review activities and outcomes to ensure ongoing compliance with regulatory requirements, internal standards and established review processes. Maintain and update materials tracking tools, logs and repositories to ensure complete and accurate documentation of review decisions and approvals. Provide program support through participation in special projects, process improvement initiatives and cross‑functional compliance efforts. Required Qualifications Bachelor’s degree or equivalent experience in a related field. 7+ years of work experience beyond the degree. Preferred Qualifications Strong knowledge of Medicare, CMS, and other healthcare regulatory requirements. Ability to interpret and apply complex regulatory guidance to materials. Experience with materials review, approval and governance processes. Experience developing workflows, SOPs or process improvements. Office role requiring onsite presence, on average, 3 days per week. Candidates located near one of the following office locations are preferred: Minnetonka, MN; Madison, WI; St. Louis, MO; or Omaha, NE. Eligibility to work in the US: Medica does not offer work visa sponsorship. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer; all qualified candidates receive consideration for employment regardless of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. #J-18808-Ljbffr