Compliance Manager – Virtual Care System

Vaga não está no LinkedIn

🕒 Julho 29

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $75.000 - $80.000 / ano

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

🚔 Conformidade

👻 Score fantasma 34%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of PreBorn!

PreBorn!

51 - 200 funcionários

🤝 Sem Fins Lucrativos

🤲 Filantropia

🏥 Saúde

Non-profit • Charity • Healthcare

A PreBorn! é uma organização sem fins lucrativos, com base nos EUA e centrada na fé, que administra uma rede de clínicas de apoio à gravidez, oferecendo ultrassons gratuitos, aconselhamento compassivo, ajuda material (fraldas, fórmula, roupas), educação parental e discipulado centrado no evangelho para dissuadir o aborto e apoiar as mães. A organização coloca máquinas de ultrassom nas clínicas, arrecada apoio de doadores (mensais e únicos) por meio de programas como "Heartbeat Heroes", e relata métricas de impacto sobre bebês salvos, compromissos com Cristo e máquinas colocadas. A PreBorn! é aprovada pelo IRS como uma 501(c)(3) e destaca suas credenciais e classificações de caridade em seu site.

Descrição

• Oversee the development, implementation, and management of coding and compliance programs for clinic and telehealth maternal care services • Ensure adherence to federal and state regulations, payer guidelines, and industry best practices • Lead and manage the risk and compliance team, including hiring, training, performance management, quality improvement, and professional development • Develop and implement policies and procedures for accurate clinical documentation, coding, and billing • Monitor regulatory changes and payer updates related to EHRs, telehealth, and maternal care • Conduct internal audits and risk assessments; identify compliance gaps and implement corrective actions • Serve as a subject matter expert on clinical documentation, CPT, HCPCS, ICD-10, HIPAA, OIG, and CMS compliance • Collaborate with legal, IT/IS, clinical, and operational teams • Provide coding and risk-mitigation guidance to clinic clients • Develop and deliver training for internal staff and external clients • Represent the organization in industry forums, conferences, and with regulatory bodies • Lead managed care partnerships focused on care coordination and improved outcomes for high-risk pregnant women • Collaborate with payers, providers, and community organizations on value-based care models and telehealth interventions • Analyze outcome data and quality metrics to improve maternal and perinatal care

🎯 Requisitos

• Agreement with and adherence to PreBorn!’s Statement of Faith and Code of Christian Conduct • Willingness to intercede before God for the ministry of PreBorn! • Fidelity to an ever-maturing biblical, evangelical lifestyle • Bachelor’s degree required in Health Information Management, Healthcare Administration, Nursing, Public Health, or a related field • RHIA, RHIT, CCS, CPC, or similar coding certification preferred • Deep understanding of telehealth regulatory requirements, billing practices, and payer requirements • Positive, team-player with a pro-active approach to problem solving • Independent, results-focused, highly organized self-starter • Ability to thrive in a fast-paced and dynamic environment, handling multiple priorities with ease and a keen attention to detail • Minimum 7-10 years of experience in healthcare risk management and quality improvement, with at least three years in a leadership role • Demonstrated experience in developing and managing payer-provider partnerships, particularly in maternal health and/or high-risk populations • Proven experience managing teams and driving performance in a remote or hybrid environment • Strong analytical, communication, and project management skills • Experience with EHR systems and coding software tools • Familiarity with value-based care models, quality metrics, and care coordination strategies

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