Careers At Sagility

Manager Compliance

Job Code : REQ-003610
Kingston Partially Remote/Hybrid

Job Description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

The Manager of Jamaica Healthcare Compliance is responsible for ensuring regulatory, statutory, and contract compliance of the Company?s Healthcare Operations (Provider and Payor) in Jamaica and working in concert with the healthcare compliance and information security teams in the United States, India, Philippines and Colombia to ensure regulatory, statutory and contractual compliance. More specifically to ensure the Federal and State Healthcare compliances specified by the Department of Health and Human Services (HHS), HIPAA 1996 and Security/Privacy Rules, HITECH Act 2009 and other healthcare related guidelines, Centers for Medicare & Medicaid Services (CMS), Medicaid Guidelines, Compliance requirements specified by the Office of Inspector General (OIG), General Services Administration (GSA), Office of Foreign Assets Control (OFAC), and licensing provisions for TPA and agent under Insurance Codes specified by the respective State?s Department of Insurance. The Manager of Jamaica Healthcare Compliance oversees the management of the Corporate Compliance Program, functioning as an independent and objective body that reviews and evaluates compliance issues and concerns within the organization. The individual selected for this position will report directly to the US Senior Director of Compliance and will be responsible for reporting incidents of compliance and ethics to the Global General Counsel to ensure all organizational operations, reporting systems and documentation comply with regulatory requirements. The Manager of Jamaica Healthcare Compliance will not, directly or indirectly, engage or participate in any outside activity that would, or may be perceived to, conflict with the best interests of the Company or his/her duties to the Company.

Job title:

Manager Compliance

Job Description:

  • Assist in maintaining, and revision of policies and procedures for the general operation of the Compliance Program to meet contractual, statutory and regulatory requirements and maintain and update, as necessary and appropriate, the World Class Compliance Program (WCCP) charter document(s).

    In collaboration with the Senior Manager for Healthcare Security and Compliance, develop and deliver timely and appropriate compliance trainings for all employees, temporary staff, executives and delegated entities (vendors) at the time of hiring or contracting and annually thereafter. The trainings should emphasize the Company?s commitment to comply with its Code of Conduct; HIPAA Privacy; HIPAA Security; Fraud, Waste and Abuse (FWA); and the WCCP.

    Participate in various Committees of the organization, including the Quality Committee and Compliance Committees.

  • Review and analyze documents submitted by other staff for compliance, provide guidance as needed to ensure the organization?s contractual obligations are met. Compile and report compliance related data or informational requests as necessary to relevant stakeholders and clients.
  • Investigate reported events, incidents, facilitate with internal departments in remediating the compliance FWA issues or incidents.
  • Coordinate with SPOCs and operational departments and actively participate in client pre-delegation audits, compliance program audits, compliance assessments, quarterly or annual compliance attestations and other ongoing monitoring activities related to compliance and FWA.
  • Assist in the coordination with Human Resources and Procurement departments to ensure all new hires are screened against the OIG/GSA Exclusion List prior to hire and monthly thereafter. This includes employees, temporary staff, consultants, executives, delegated entities (vendors) and the governing body.
  • Establish and maintain clear consistent and an effective communication related to compliance and FWA with all levels of staff, including, but not limited to updated compliance posters at all office locations and intranet updates in coordination with Human Resources, Legal, Information Security, and Corporate Communications departments.
  • Assist in the preparation and execution of quarterly Compliance Reports for the Board of Directors on the effectiveness of the compliance programs and practices and provide direct reporting of compliance issues or incidents that rise to the level of discretionary or mandatory reporting to the US Senior Director of Compliance and Global General Counsel.
  • Perform other duties as assigned.


Kingston, JamaicaJamaica