Manager Compliance Investigations

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary Responsible for the effective operation of the Corporate Integrity Hotline and related responsibilities in accordance with HCSC’s Compliance Charter, Compliance Program, and U.S. Department of Justice Guidelines.

Ensures timely and detailed investigation/resolution of hotline inquiries/allegations of misconduct and violations of the law. Responsible for the analysis of all reported allegations and the subsequent preparation of detailed reports for senior leadership.

Required Job Qualifications: Bachelor’s degree in Criminal Justice, Legal Studies, Risk Management, Business, Human Resources, or related field and 5 years of investigative experience in a compliance environment or its equivalent involving researching and investigating inquiries OR 9 years of investigative experience in a compliance environment or its equivalent involving researching and investigating inquiries. 1 year of management/leadership experience. Knowledge of and/or experience in Ethics & Compliance Hotline Operations, metrics, analysis and reporting.

Familiarity with external governmental agencies (i.e., EEOC, Department of Human Rights, CMS, OIG, etc.). Knowledge of and/or experience with the 7 elements of a compliance program. Knowledge of and/or experience in policy and procedure documentation. Organizational decision-making and analytical skills. Strong interpersonal skills. Listening skills and ability to accurately document information reported. Ability to influence processes to achieve results. Ability to work independently, with guidance in only the most complex situations.

Support of high priority projects with highest level of confidentiality. Effective verbal and written communication skills (Clear and concise verbal & written communication skills). Preferred Job Qualifications: Prior Law Enforcement or Military experience. Juris Doctorate. Certified Fraud Examiner (CFE) designation. Certified Compliance & Ethics Professional (CCEP) designation. Certified in Healthcare Compliance (CHC) designation. Proven success managing employees, fostering team development, and achieving business objectives through effective leadership.

This is a Flex (Hybrid) role: 3 days in office; 2 days remote. Sponsorship is not available. #LI-LO1 #LI-Hybrid Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience.

This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $92,700.00 - $167,500.00 Exact compensation may vary based on skills, experience, and location. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families.

As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

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Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

• Bachelor’s degree in related field plus 5 years investigative compliance experience, or 9 years investigative experience without degree
• Minimum 1 year management/leadership experience
• Knowledge of Ethics & Compliance Hotline operations, external agencies, compliance programs, and policy documentation