Senior Compliance & QA Specialist

Summary

This role leads Spark's ongoing monitoring of its downline agencies, from risk-tiering methodology through corrective action, and owns the carrier-facing and executive-level reporting that documents Spark's oversight of its network. The Senior Specialist works closely with the Compliance & QA Supervisor and Head of Compliance and operates with a high degree of autonomy on day-to-day program decisions, escalating only complex or precedent-setting issues.

This role is ideal for an experienced compliance professional who wants to lead an agency monitoring program, serves as a go-to subject matter expert for the department, and is comfortable representing compliance externally with carriers and internally with leadership.

What You'll Do

Downline Agency Monitoring & Risk Oversight (40%)

Lead the Monitoring Framework: They lead the design and evolution of Spark's risk-based monitoring framework for downline agencies, including risk-tiering methodology and monitoring thresholds, operating with minimal day-to-day oversight from the Supervisor and Head of Compliance.

Cross-Functional Input: They partner with call quality and case management functions to ensure QA and case findings are incorporated into agency risk tiers.

Program-Level Trend Analysis: They independently analyze monitoring data to identify systemic or emerging agency-level risks, and bring findings and recommended program changes directly to the Head of Compliance.

Carrier & Executive Reporting (25%)

Own Carrier Reporting: They own the development of carrier-facing compliance reports summarizing Spark's oversight actions and outcomes for its downline agencies.

Own Executive Reporting: They build and maintain executive-level dashboards and reporting on agency monitoring performance for department and company leadership.

Carrier Point of Contact: They serve as a key point of contact for carrier partners on monitoring-related reporting requests.

Corrective Action & Remediation (20%)

Own Corrective Actions: They independently develop, negotiate, and manage Corrective Action Plans (CAPs) and Performance Improvement Plans (PIPs) for agencies and agents, including carrier-facing CAP submissions for high-risk cases.

Root Cause Analysis: They lead root cause analysis on significant compliance issues and translate findings into remediation plans and program-level improvements.

Coaching & Education: They design coaching materials and lead office hours to address emerging compliance issues across the program.

Department SME & Cross-Functional Partnership (15%)

Subject Matter Expertise: They serve as a subject matter expert for the Compliance department on CMS Medicare marketing and agent oversight requirements, fielding questions from across the team.

Mentorship: They mentor and advise less experienced compliance specialists on complex cases and monitoring decisions, without formal management authority.

Cross-Functional Representation: They represent compliance in cross-functional and carrier-facing discussions on downline agency oversight, including coaching and education efforts for agencies.

What We're Looking For

Deep subject matter expertise in CMS regulations governing downline agency oversight, including CTM Rate and Non-CTM Founded Rate as risk-tiering inputs, and telephonic enrollment standards.

Proven ability to independently lead and evolve an agency monitoring or risk-tiering program, not just execute within one.

Strong analytical skills with the ability to translate raw data (call scores, case details) into insights and reports that inform program strategy and agency risk-tiering.

Excellent coaching and mentoring skills, including upskilling less experienced compliance specialists.

Highly organized, with an ability to manage and prioritize multiple complex workflows.

Outstanding communication and interpersonal skills, capable of working effectively with agents, internal teams, leadership, and carrier partners.

Proficiency with Google Workspace and experience with compliance workflow or case management software.

CompensationOur salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Spark. In accordance with New York City, Colorado, California, and other applicable laws, Spark is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is listed below. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.

Base Salary

$85,000—$115,000 USD