Eleanor Gillis
Rosharon ,TX
Summary
Dynamic compliance leader with extensive experience driving regulatory adherence and risk management initiatives. Proven track record in enhancing operational efficiency and stakeholder engagement. Expertise in Corporate Integrity Agreement oversight and ethics governance, successfully implementing strategic compliance programs that significantly improved organizational effectiveness. Meticulous and knowledgeable compliance manager with a several-year record of success in policy development, program management, risk mitigation and operational planning. Proficient in maintaining regulatory compliance and correcting systemic issues in collaboration with business managers. Team-focused, consistent and diplomatic with a focus on building strategic alliances and enhancing company standing.
Overview
18
18
years of professional experience
Work History
Consultant
EMIDS Technology
Remote, TX
02.2025 - 09.2025
- Led client consultations to identify technology and automation, to include AI solutions, and strategic goals.
- Facilitated cross-functional team meetings to drive project alignment and collaboration.
- Collaborated with clients to develop action plans to address specific challenges and objectives.
- Provided advice on operational processes, via job mapping solutions, staffing recommendations initiatives, organizational changes, and other areas of improvement.
- Deeply involved in critical strategic and operational initiatives for process transformation initiatives.
- My core responsibilities revolved around optimizing processes and scaling operations across vital functions, specifically Marketing, Communication, and Compliance, to drive efficiency, and enhance overall organizational effectiveness.
- A significant aspect of my role included collaborating closely with Corporate Counsel, Legal Governance stakeholders, and senior management to strategically evaluate and seamlessly integrate artificial intelligence technologies (AI), aiming to innovate and streamline various operational facets.
- Successfully managed a crucial project involving the complex migration of First Tier, Downstream, and Related Entities (FDR) oversight, and issue management responsibilities for both corporate and health plan entities. This initiative was pivotal in establishing more effective reporting mechanisms, and strengthening compliance protocols.
- Led comprehensive updates to existing governance, risk, and compliance (GRC) workflows and processes. These enhancements were designed to substantially improve operational efficiency, mitigate risks, and ensure stringent alignment with evolving regulatory requirements, and industry best practices.
Legal Compliance Sr. Advisor
Cigna Health Group
Remote, TX
05.2024 - 02.2025
- Oversaw regulatory compliance standards for all Enterprise, Federal Healthcare Government Programs.
- Facilitated improvement of Federal healthcare compliance program alongside Senior Counsel.
- Executed risk-based compliance work plans incorporating FHCP laws and industry best practices.
- Administered operations of Federal Programs Compliance Committee to enhance oversight.
- Supported risk assessment and internal review processes for Federal healthcare programs.
- Developed and monitored sufficiency of mitigation work plans and corrective action plans.
- Collaborated with compliance staff for audits, including annual reviews by Independent Review Organization.
- Tracked disclosures through Cigna's Disclosure Program, addressing potential Reportable Events.
Associate Compliance Director
UCare
Remote, TX
05.2023 - 05.2024
- Oversaw UCare’s Compliance and Ethics Program, ensuring adherence to federal and state regulations.
- Directed fraud, waste, and abuse prevention initiatives to uphold ethical standards.
- Managed four Compliance Specialists, reporting directly to Chief Compliance Officer and Board of Directors.
- Chaired Sub-Delegation Oversight and Regulatory Change Management Committees, delivering quarterly compliance reports.
- Analyzed compliance program structure, enhancing educational requirements and reporting mechanisms.
- Coordinated compliance with federal and state laws affecting Medicare Advantage and Medicaid managed care plans.
- Maintained vendor relationship with Compliance 360 for incident management and hotline monitoring.
- Streamlined auditing processes to strengthen oversight of compliance initiatives.
Business Communications Audit Advisor
Cigna HealthSpring
Remote, TX
03.2021 - 05.2023
- Transitioned to a new role in Customer Correspondence Governance within Customer and Client Service Experience.
- Executed ongoing risk management activities as Business Communications Audit Advisor, ensuring compliance with state and federal regulations.
- Collaborated with Operations Matrix Partners and enterprise senior leaders to optimize operational communications.
- Triaged internal and external marketing materials to mitigate customer complaints and compliance issues.
- Enhanced communication channels to address evolving needs of members and business partners.
- Drove process improvement initiatives in an Agile environment, focusing on technology-enabled solutions.
- Contributed to strategies that increased customer satisfaction and reduced retention rates.
- Fostered collaboration among teams to improve response efficiency and operational effectiveness.
Legal Compliance Advisor
Cigna HealthSpring
Remote, TX
09.2018 - 03.2021
- Acted as subject matter expert for Part C Medicare Advantage line of business.
- Provided support for cross-functional operations to ensure compliance with federal and state regulations.
- Monitored Medicare Advantage guideline changes, collaborating with partners for effective implementation.
- Managed Corrective Action Plan to address root causes and ensure compliance.
- Analyzed controls for strengths and weaknesses, reporting high-risk business areas.
- Facilitated CMS Readiness activities, including ad-hoc mock audits for business preparedness.
Operational & Regulatory Compliance Director
FCL Dental
Sugarland, TX
02.2016 - 05.2018
- Directed organizational oversight of Quality Improvement operations and Compliance Program activities.
- Executed internal and external regulatory interpretations to ensure adherence.
- Conducted enterprise risk assessments and facilitated communication for implementation.
- Developed and delivered training programs to enhance operational compliance.
- Monitored operations through audits and state and federal reporting on contractual obligations.
- Managed day-to-day client communications addressing performance and noncompliance issues.
- Chaired Compliance Committee and co-chaired Quality Improvement Committee.
- Supervised Compliance Coordinator in executing compliance-related tasks.
Sr. Regulatory Compliance Specialist
Molina Healthcare of Texas
Hybrid, TX
09.2014 - 02.2016
- Developed TX Compliance program for multiple business lines, including Medicaid Managed Care and Marketplace.
- Served as Compliance subject matter expert for Business Development during expansion RFP communications.
- Supported Compliance Director with hotline operations to uphold business integrity and regulatory compliance.
- Implemented system-wide initiatives in complex compliance policies, risk management, and education training.
- Assisted in annual development and monitoring of internal oversight program Work Plan, analyzing risks.
- Acted as interim Compliance Director for eight months, managing two remote Compliance staff members and providing leadership.
Manager, Compliance Monitoring and Auditing
Universal American Corp.
Houston, TX
10.2007 - 12.2013
- Coached and developed five Compliance Specialists to enhance operational compliance across all product lines.
- Executed audits of policies, regulations, and accreditation standards based on annual work plans.
- Implemented multi-line defense strategies that drove process improvements and ensured sustained compliance.
- Conducted self-monitoring and auditing within business units to uphold rigorous internal controls.
- Developed training programs focused on compliance obligations for staff education.
- Prepared business areas for regulatory audits through mock audits and participation in site surveys.
- Reported audit outcomes and assisted in developing corrective action plans.
- Facilitated departmental corrective action procedures and rebuttal processes efficiently.
Education
B.A. - Business Administration
Prairie View A&M University
Prairie View, TX12-2002
Skills
- Corporate Integrity Agreement oversight
- Ethics & Compliance Governance
- Compliance leadership
- Risk management
- HCCA Speaker 2010 – “Tackling the Challenges of Delegation and Vendor Oversight”
- Stakeholder engagement
- Regulatory compliance
Education Certifications
- Six Sigma, Certification of Kaizen
- Lean Six Sigma, Certification of Yellow Belt
- HCCA, Certification in Healthcare Compliance, Expired
Timeline
Consultant
EMIDS Technology
02.2025 - 09.2025
Legal Compliance Sr. Advisor
Cigna Health Group
05.2024 - 02.2025
Associate Compliance Director
UCare
05.2023 - 05.2024
Business Communications Audit Advisor
Cigna HealthSpring
03.2021 - 05.2023
Legal Compliance Advisor
Cigna HealthSpring
09.2018 - 03.2021
Operational & Regulatory Compliance Director
FCL Dental
02.2016 - 05.2018
Sr. Regulatory Compliance Specialist
Molina Healthcare of Texas
09.2014 - 02.2016
Manager, Compliance Monitoring and Auditing
Universal American Corp.
10.2007 - 12.2013
B.A. - Business Administration
Prairie View A&M University