Department Spotlight: Compliance

Tufts Health Plan has a spectrum of insurances that include Medicaid, Medicare, and duals programs. In compliance, our focus is to comply with state and federal regulations for these programs while always keeping the needs and wellbeing of our members front and center. This takes a unique combination of strategy, problem solving, intellectual rigor and compassion, which our team members all share.

What’s it like working in Compliance at Tufts Health Plan?

• Intellectually Stimulating: Healthcare is a complex and constantly changing industry. Our job is not only to fully understand both internal and external rules and policies, but to thoughtfully interpret and explain them in real-world situations that often directly affect our members’ lives.
• Varied: The issues we tackle are as diverse as the people who work here. Each day we solve a multitude of challenges and problems, some straightforward, others complex. Our team members need to be able to think on their feet, track down answers, and make sound decisions about what is and isn’t possible within the bounds of the law.
• Collegial: Our goal, always, is to help legally enable what’s best for our members’ health. This requires a non-adversarial attitude—working together in a positive, productive way with our colleagues in our department, in other areas of the organization and at government agencies.

Words that describe our team members:

Detail-oriented. Intellectually curious. Helpful. Collaborative. Considerate. Honest.