About this role
Role Description
The Compliance Manager provides leadership for assigned components of the compliance program and is responsible for overseeing day-to-day program support activities and team deliverables. This role partners with leadership to:
Advance compliance priorities Support risk-informed decision-making Strengthen accountability Promote a culture of ethics and integrity
The Compliance Manager has direct management responsibility for assigned staff and retains overall accountability for the quality, coordination, escalation, and completion of work within areas of responsibility. This role leads, coaches, and holds staff accountable for:
Performance Work quality Timeliness Professional development Adherence to organizational expectations
The Compliance Manager has direct oversight of work allocation, priorities, deliverables, and quality for team members and support staff engaged in compliance operations.
Responsibilities
The essential duties and responsibilities (including but not limited to):
Governance: Owns day-to-day implementation and monitoring of assigned components of the compliance program. Accountable for alignment of related operations support activities with organizational policies, procedures, and applicable federal and state requirements. Owns development and final quality of timely compliance committee materials. Owns monitoring of relevant regulatory and enforcement developments. Culture and Training: Owns targeted compliance education and related communications for employees and leaders. Owns follow-up to employee and compliance culture survey results. Investigations and Risk Response: Owns intake, tracking, triage, and follow-up of compliance concerns. Owns payor audit activity. Owns assigned compliance investigations. Owns the compliance work plan. Policy and Program Administration: Owns development, review, maintenance, and communication of compliance-related policies. Owns sustainable management of SharePoint and communication content. Owns special projects and program improvement initiatives.
Qualifications
Bachelor’s degree in healthcare administration, business administration, or a related field. Minimum five (5) to seven (7) years of progressive healthcare compliance experience in a physician group, provider, or healthcare operations environment required. Minimum five (5) years of experience in investigations, auditing and monitoring, corrective action planning, policy development, training, governance support, or program administration. Minimum two (2) years of direct supervisory or people leadership experience required. Demonstrated ability to manage multiple compliance workstreams. Working knowledge of healthcare compliance principles, privacy requirements, reimbursement and documentation standards. Proficiency in Microsoft 365 applications. Strong analytical, organizational, written communication, and stakeholder collaboration skills.
Preferred Qualifications
Experience in a physician group or oncology environment. Strong auditing background or prior internal audit experience. Certified in Healthcare Compliance (CHC) certification.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Regularly required to experience prolonged sitting, some bending, stooping, and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate office equipment. Requires normal range of hearing and eyesight correctable to 20/20. Occasional lifting of up to 30 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Exposed to conditions typical in a medical office setting. Work will require significant travel throughout the state, approximately 10% of the time.