Brandon T. Tucker
Healthcare Compliance Executive
Miami Beach,FL
Summary
Compliance Management Executive with over 20yrs. of Healthcare Expertise in FDR Oversight, Regulatory Governance, Federal CMS Compliance, AI Healthcare Policy Implementation, & Enterprise Risk Management: Driving Alignment between Federal Mandates & Corporate Objectives.
Overview
25
25
years of professional experience
Work History
Compliance Regulatory Auditor
HEALTHAXIS GROUP, LLC
Tampa, FL
07.2024 - Current
- Directing nationwide regulatory audits & AI policy adherence to CMS, HHS, and QHP standards.
- Shaping risk management strategies by evaluating enterprise processes and controls, driving corrective actions, and aligning compliance operations with evolving regulatory requirements: including AI governance.
- Leading cross-functional audit teams to strengthen oversight, drive remediation, and promote a culture of compliance.
- Managing vendor compliance programs through annual risk assessments, monitoring, and mitigation strategies to reduce organizational risk and maintain contractual obligations.
- Providing direction for AI implementation & audits for adherence to CMS, HHS, and QHP regulatory standards.
- Overseeing vendor compliance via risk-based assessments, continuous monitoring, and mitigation strategies.
Compliance Reviewer
STRATEGYGEN / HEALTHCARE MANAGEMENT SOLUTIONS, LLC
Columbia, MD
06.2021 - 07.2024
- Oversaw nation-wide regulatory compliance audits of Qualified Health Plan (QHP) issuers to ensure adherence with CMS protocols, Affordable Care Act (ACA) requirements, and contractual obligations.
- Partnered with federal oversight bodies to strengthen compliance frameworks and monitoring programs.
- Directed compliance audits of QHP issuers to ensure adherence to CMS, ACA, and contractual requirements.
- Oversaw corrective action plans while partnering with CMS/CCIIO to refine audit criteria and strengthen oversight.
Compliance Consultant
HEALTHSUN HEALTH PLANS, INC., an ELEVANCE COMPANY
Coconut Grove, FL
02.2018 - 11.2019
- Directed enterprise-wide compliance initiatives, serving as the primary lead for FDR oversight audits, regulatory monitoring, and compliance reporting.
- Partnered with leadership and business units to ensure alignment with CMS mandates, mitigate compliance risks, and strengthen organizational accountability.
- Directed FDR oversight audits, monitoring, and regulatory reporting in alignment with CMS mandates.
- Provided strategic compliance leadership and oversight of policy, audit framework, and training initiatives.
Credentialing & Compliance Consultant
HNI HEALTHCARE, INC.
Austin, TX
05.2016 - 10.2017
- Provided executive leadership for national credentialing oversight, ensuring compliance with federal and state regulations while strengthening governance, mitigating organizational risk, and enhancing enterprise-wide operational efficiency.
- Served as the primary liaison for physician communications and state-level credentialing, partnering with executive leadership and the board to advance regulatory alignment, provider compliance, and long-term healthcare objectives.
- Directed enterprise credentialing strategy and governance, strengthening organizational integrity and compliance.
- Provided strategic compliance insights, enhancing optimized operations and physician/stakeholder relations.
Compliance Consultant
SIMPLY HEALTHCARE PLANS, INC., an ELEVANCE COMPANY
Miami, FL
10.2012 - 05.2016
- Served as a primary compliance consultant supporting enterprise-wide regulatory adherence and risk management for a leading international healthcare organization.
- Partnered with leadership and internal business units to strengthen oversight programs and ensure compliance with evolving regulatory requirements.
- Guided internal business units in oversight monitoring, measurement, and compliance training activities.
- Led risk assessments, mitigation strategies, and evaluation of audit findings and performance trends.
Education
Doctor of Philosophy - Leadership & Administration
Saint Patrick University
03.2024
Master of Arts - Leadership & Administration
Saint Patrick University
09.2022
Skills
- AI Healthcare Policy Adherence & Training
- CMS, HHS, QHP Regulatory Compliance
- FDR Oversight & Vendor Governance
- HIPAA Privacy & Security Management
- Audit Leadership & Corrective Action Planning
- CMS, CCIIO Audit & Compliance Oversight
- ODAG Audit Readiness & Risk Management
- FFE Federally-Facilitated Exchange – FFM Marketplace
- Affordable Care Act & Policy Adherence Management
- Policy Implementation of Code of Federal Regulations
- Credentialing Systems (CAQH, MD-Staff)
- EMR Software Policy Management
- Google Workspace
- Microsoft Office Suite
- Excel - advanced analytics
- Microsoft Word
- PowerPoint
- Outlook
- Compliance/Audit Platforms (TeamMate)
- AI Regulatory Implementation
- Adobe
- DocuSign
- SharePoint
- Acrobat Pro
Websites
Personal Information
Title: Senior Healthcare Compliance & Regulatory Executive
Certification
Health Care Compliance Association (HCCA) Certified in Healthcare Compliance (CHC);
Exam Certification Pending Q4-2025
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Affiliations
- Health Care Compliance Association
- Society of Corporate Compliance & Ethics
Languages
English
Native or Bilingual
Timeline
Compliance Regulatory Auditor
HEALTHAXIS GROUP, LLC
07.2024 - Current
Compliance Reviewer
STRATEGYGEN / HEALTHCARE MANAGEMENT SOLUTIONS, LLC
06.2021 - 07.2024
Compliance Consultant
HEALTHSUN HEALTH PLANS, INC., an ELEVANCE COMPANY
02.2018 - 11.2019
Credentialing & Compliance Consultant
HNI HEALTHCARE, INC.
05.2016 - 10.2017
Compliance Consultant
SIMPLY HEALTHCARE PLANS, INC., an ELEVANCE COMPANY
10.2012 - 05.2016
Master of Arts - Leadership & Administration
Saint Patrick University
Doctor of Philosophy - Leadership & Administration
Saint Patrick University
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