Quality & Compliance Lead at Benefits All In LLC – Cincinnati, Ohio

Position Overview

Benefits All In, located minutes from downtown Cincinnati, is a healthcare consulting firm dedicated to helping employers build programs that support the unique insurance needs of their employees. Our mission is to provide expert guidance and resources that bring peace of mind to families while making healthcare more affordable.

We are seeking a Quality & Compliance Lead to oversee regulatory compliance, quality assurance, and documentation governance within our RM Department. This role ensures regulatory alignment, maintains documentation integrity, and reviews high-impact case decisions to protect both member outcomes and organizational risk.

The ideal candidate is detail-oriented, experienced in compliance and quality review processes, and comfortable collaborating across teams to maintain consistent standards.

Benefits All In offers a collaborative work environment and a hybrid schedule with the ability to work remotely up to two days per week. If you have a growth mindset, strong attention to detail, and a passion for helping others, we encourage you to apply.

Key Responsibilities

Regulatory & Compliance Oversight

Ensure adherence to Medicare regulations, licensing requirements, and HIPAA standardsMonitor regulatory updates and implement necessary compliance framework changesDevelop and maintain compliance policies and standard operating procedures (SOPs)Maintain documentation standards and compliance librariesPartner with Learning & Development to support regulatory training and continuing education

Quality Assurance & Audit Management

Oversee quality review systems including:KPI monitoringRecorded call reviewsDocumentation auditsPerformance rubric evaluationsConduct regular compliance and quality auditsPartner with leadership to implement corrective action plans and reinforce standards

High-Impact Case Review & Verification

Review complex, high-claimant household cases before recommendations are presentedValidate coverage options, provider alignment, and documentation completenessEnsure required materials and plan comparisons are properly documented in SalesforceReview “Lost” or “Stalled” opportunity decisions to confirm all viable options were exploredMaintain governance over high-risk cases to ensure consistent documentation and decision accuracy

Risk Management & Oversight

Identify potential compliance and operational risk areasMonitor complex member scenarios to reduce regulatory exposureImplement safeguards to strengthen documentation accuracy and decision validation

Reporting & Documentation Governance

Maintain detailed audit records and compliance documentationPrepare reporting insights for leadershipEnsure all high-impact case reviews and audit outcomes are documented in Salesforce

Cross-Functional Collaboration

Serve as a primary point of contact for compliance-related guidancePartner with Team Leads, Account Managers, Account Executives, and Learning & Development teamsProvide guidance on documentation best practices and regulatory standards

Systems & Monitoring

Utilize Salesforce and Microsoft tools to track compliance activity, quality audits, and case reviewsSupport development of dashboards and monitoring tools to improve operational oversight

Qualifications

Required

Experience in compliance, quality assurance, or regulatory oversightKnowledge of HIPAA and regulated environmentsStrong analytical skills with the ability to evaluate documentation and case outcomesExperience conducting audits or quality reviewsExperience working within CRM systems such as SalesforceExcellent attention to detail and documentation discipline

Preferred

Experience in healthcare, Medicare, or insurance-related environmentsExperience developing compliance policies or SOPsExperience working with operational performance metrics or KPI monitoring

Skills & Competencies

Regulatory Compliance & GovernanceQuality Assurance & AuditingRisk Assessment & MitigationDocumentation Accuracy & Process OversightCross-Functional CollaborationAnalytical Decision ValidationProcess Improvement

Benefits include a competitive base salary, being part of a growing company, as well as a competitive and comprehensive benefits package including 401k, attractive healthcare coverage, dental, vision, and employer-paid life insurance, ample paid time off, and a hybrid work schedule.