The Compliance Manager, reporting to the System Director of Compliance, will be responsible for implementing and facilitating components of the organizational compliance program and work plans including but not limited to compliance investigations, compliance training and education, compliance audits and monitoring of corrective action plans, policies and procedures, risk assessments, and compliance communications. In addition, the Compliance Manager will continuously monitor and analyze state and federal legislation to determine impact on The HSC Health Care System.
Bachelor’s Degree (Required)
Master’s Degree in health law, health administration, or business administration (Preferred) Or
Juris Doctorate (J.D.) (Preferred)
Minimum Work Experience
5 years years of experience in a healthcare compliance-related role. (Required)
2 years years of experience in conducting healthcare compliance investigations and compliance audits. (Required)
Working knowledge of Medicaid in an integrated health care delivery system (ideally a system with hospital, home health, and managed care entities).
Critical thinking with excellent research and analytical skills.
Proficiency in identifying, assessing, and reporting compliance gaps and/or internal controls, articulating appropriate recommendations, monitoring and testing for compliance.
Clear, concise technical writing and presentation skills.
Keen attention to details.
Proficiency in Microsoft Office Suite products (including Word, Outlook, Excel, and PowerPoint).
Required Licenses and Certifications
Must have one of the following certifications (Required):
Certified Internal Auditor (CIA)
Certified Fraud Examiner (CFE)
Accredited Healthcare Fraud Investigator (AHFI)
Certified in Healthcare Compliance (CHC)
Certified Compliance and Ethics Professional (CCEP)
Essential job duties:
Develop, facilitate, implement, continuously evaluate, and update the Compliance Work Plan to include the following:
a. Revise/draft compliance and privacy policies and procedures
b. Training and education programs
c. Audits and investigations
d. Risk assessments
Respond to internal and external stakeholders regarding compliance-related issues.
Conduct investigations of potential compliance gaps.
Plan, conduct and coordinate compliance audits.
Develop and oversee implementation of compliance and privacy-related work plans.
Monitor and assess legislative and regulatory developments to determine organizational impact.
Performs other duties as assigned.