4460 Manager Compliance & Regulatory

Develops, implements, and oversees components of the organization's healthcare compliance program to ensure adherence to federal and state regulations, accreditation standards (if applicable), and internal policies. Provides strategic direction for compliance initiatives to mitigate risk and maintain regulatory compliance across the organization.

Education

• Bachelor's degree in Healthcare Administration, Business, Law, or related field
• Master's degree in Healthcare Administration, Business Administration, Law, or related field preferred

Requirements

• Continuously improve the company’s comprehensive compliance programs, policies, and procedures to ensure adherence to healthcare regulations including HIPAA, Medicare/Medicaid requirements, and fraud and abuse laws,
• Background from RCM OR Medical Coding is preferred.
• Conduct regular risk assessments to identify potential compliance vulnerabilities and develop corrective action plans to address identified issues
• Oversee and perform internal monitoring and auditing processes to evaluate compliance with federal and state regulations and organizational policies
• Investigate potential compliance violations, recommend corrective actions, and implement preventive measures to mitigate future risks
• Serve as a liaison during audits or investigations
• Develop and deliver compliance training programs for staff at all levels of the organization
• Prepare comprehensive compliance reports to various stakeholders including department leaders and executive leadership
• Leverage technology and analytics to enable actionable, effortless, and shared reports
• Collaborate with legal counsel and information security teams to address complex compliance matters
• Stay current on healthcare regulatory changes and emerging compliance trends to ensure organizational policies remain up to date
• Perform other compliance-related tasks as requested

Experience

• Minimum 5-7 years of progressive experience in healthcare compliance
• At least 3 years of oversight of a compliance program within a company
• Demonstrated experience developing and implementing compliance programs in healthcare settings

Technical Skills

• Comprehensive knowledge of healthcare regulatory frameworks including HIPAA, HITECH, Medicare/Medicaid regulations
• Strong understanding of healthcare fraud and abuse laws (Anti-Kickback Statute, Stark Law, False Claims Act)
• Proficiency in compliance risk assessment methodologies and audit techniques
• Experience with compliance management software and data analysis tools
• Knowledge of healthcare accreditation standards (Joint Commission, NCQA, etc.)

Soft Skills

• Exceptional leadership abilities
• Strong analytical and problem-solving skills
• Excellent written and verbal communication skills
• Ability to influence and collaborate with stakeholders at all levels
• High level of integrity and ethical decision-making

Preferred Qualifications

• Certified in Healthcare Compliance (CHC) certification
• Additional certifications preferred: Certified in Healthcare Privacy Compliance (CHPC) or Certified Compliance and

Ethics Professional (CCEP)

• Experience in multiple healthcare settings (physician practice, health plan)
• Experience in revenue cycle management and/or delegated services
• Knowledge of emerging healthcare compliance issues related to telehealth, digital health, or value-based care models

Benefits

Here’s What We Offer

• Generous PTO Benefits:  Enjoy PTO benefit accrual of 20 days per year.

• Parental Leave:  Experience one of the industry's best parental leave policies to spend time with your new addition.

• Rewards & Recognition:  Unlock your potential and be rewarded generously with both monetary incentives and widespread recognition for your dedication and outstanding performance. Unlock your potential and be rewarded generously with both monetary incentives and widespread recognition for your dedication and outstanding performance.

• Insurance Benefits:  We offer medical, dental, and vision benefits along with 100% company-sponsored short and long-term disability and basic life insurance. Legal aid and pet insurance options are available at a discounted rate.

The company is an equal opportunity employer. We celebrate diversity, and we are committed to fostering an inclusive and diverse workplace where all employees, regardless of race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, marital status, or veteran status, feel valued and empowered.

Disclaimer:  the company does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR department at [link for members] Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details.

About the company

The company activates the flow of healthcare data, empowering providers, payers, and government organizations to deliver intelligent and connected experiences that advance health outcomes. The Healthcare Intelligence Cloud equips every stakeholder in the patient journey to turn fragmented data into proactive, coordinated actions that elevate the quality of care and drive operational performance. Leading healthcare organizations like CommonSpirit Health, Atlantic Health, and Banner Health trust the company to integrate a system of intelligence into their existing infrastructure— extending the human touch in healthcare. For more information, visit .