Compliance Manager, RN

Job not on LinkedIn

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $132k - $165k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

👻 Ghost score 0%

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Habitat Health

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 2023

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Habitat Health is a healthcare organization focused on empowering older adults to live independently in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), Habitat Health provides comprehensive health insurance coverage and medical and social care services. Their services include transportation, personal care, 24/7 care access, physical therapy, nutrition support, pharmacy and prescriptions, medical care, and social services. Operating in partnership with notable healthcare providers such as Kaiser Permanente, Habitat Health is committed to creating a supportive and inclusive environment for both participants and staff, ensuring the provision of personalized, coordinated care. Founded in 2023, the company aims to enhance the lives of older adults covered by Medicare or Medicaid.

📋 Description

• Oversee successful outcomes for Centers for Medicare & Medicaid Services (CMS) and State Administering Agency (SAA) audits • Partner with leadership to foster a culture of compliance • Conduct audit readiness activities, including monitoring audit universe data, training, policy/procedure review, and process review • Manage live audits and serve as point of contact with CMS and SAA audit teams • Perform submission quality assurance • Develop, approve, and monitor corrective action plans • Provide expertise on PACE audit data, trends, best practices, risk mitigation, audit-related questions, and business development components • Report audit-related metrics to the Chief Medical Officer, Executive Compliance Committee, and compliance subcommittee of the Board of Managers • Recommend updates to the Compliance Department’s annual auditing and monitoring workplan • Recommend business focus areas based on audit findings and PACE regulatory trends • Collaborate with Population Health and Practice Operations teams on audit impacts to the Quality Improvement Program and center operations • Represent and champion the compliance program across Habitat Health • Develop and maintain productive relationships with staff at all levels • Perform other Compliance Department duties as needed • Travel, including travel supporting regulatory audits, as required

🎯 Requirements

• Minimum of three (3) years of experience in healthcare audit or related field • Active and unrestricted Registered Nurse (RN) License • Experience in PACE compliance highly preferred • Equivalent combination of education and experience sufficient to successfully perform the essential duties may qualify • Ability to lead with influence • Ability to work in a fast-paced environment and in an efficient manner • Excellent organizational skills and attention to detail • Ability to review and interpret data and make data-based recommendations • Excellent interpersonal, verbal, and written communication skills • Ability to manage multiple projects and identify opportunities for internal and external collaboration • Knowledge of the Microsoft 365 suite • Must comply with applicable infection control protocols, PPE requirements, and vaccination requirements associated with the role and work location • U.S. work authorization is verified through E-Verify after accepting an offer • Bachelor’s degree in health care administration, public health, health care operations, public policy, or a clinical field (nice to have) • Certified in Healthcare Compliance (CHC) (nice to have) • Experience with DHCS and/or CMS (nice to have) • Working knowledge of Epic (nice to have) • Experience developing or delivering compliance training to adult learners (nice to have)

🏖️ Benefits

• Target annual bonus of 10% • Additional incentive compensation, as applicable • Medical, dental, and vision insurance • Paid parental leave • Short- and long-term disability coverage • Life insurance • Flexible spending accounts • 401(k) savings plan with a match • Paid time off • Company paid holidays • Reasonable accommodations for disabilities and sincerely held religious beliefs, practices, or observances • Remote work arrangement • Travel expenses or travel support implied for required business travel