Healthcare Investigations Manager

Job not on LinkedIn

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🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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OpenLoop

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2020

💼 Consulting

⚖️ Legal

📦 Logistics

💰 $15M Series A - OpenLoop Health on 2023-03

Consulting • Legal • Logistics

OpenLoop is a white-label telehealth platform and managed services provider that helps organizations launch and scale virtual care programs. It combines SaaS-based, brandable technology (scheduling, booking, payments, EHR/API integrations) with clinical staffing, credentialing, payer coverage and RCM, regulatory/legal support, and 24/7 patient support. OpenLoop serves health plans, hospitals and health systems, retailers, employers and digital health companies with AI-powered operations, a nationwide clinician network and broad insurance coverage including Medicare and Medicaid.

📋 Description

• Own intake, triage, and investigation of compliance hotline reports • Assign cases to team members based on expertise and capacity, with guidance on investigation procedures and standards • Conduct thorough investigations by gathering facts, interpreting policy, analyzing data, and handling sensitive matters discreetly • Recognize when escalation is necessary • Own response and corrective-action workflows, define findings, drive remediation, confirm closure, and document investigative steps through resolution • Own Policy Gap analysis • Investigate potential HIPAA and Security Policy violations in coordination with IT Security • Conduct monthly and new-vendor exclusion screenings against federal and state exclusion lists • Coordinate self-disclosures and escalations with Legal and compliance leadership • Prepare quarterly investigation and disclosure-program reports for senior leadership and the Compliance Committee/Board • Identify trends and support risk-assessment discussions • Administer compliance case-management and exclusion-screening platforms, including configuration, user access, and data integrity • Manage and develop 2–3 direct reports • Build team capacity as hotline volume scales • Perform other duties as assigned

🎯 Requirements

• Experience running a healthcare investigations or hotline function full-time, ideally in a compliance or regulatory setting • Direct experience investigating HIPAA/Security Policy violations, ideally in coordination with an IT Security team • Hands-on experience administering a compliance case-management or hotline platform • Comfortable preparing and presenting investigation trends and disclosure-program data to senior leadership • Strong root-cause analysis and audit-ready documentation discipline • Strong Policy gap analysis and working with leaders to implement changes • Familiarity with OIG guidance, particularly Elements 4 and 7 • Comfortable managing a small team while staying hands-on with casework, especially in an early build phase • CHC (Certified in Healthcare Compliance) preferred • High integrity, low-ego collaborator across Legal, Compliance, IT Security, and Operations

🏖️ Benefits

• Medical, Dental, and Vision plans • Flexible Spending/Health Savings Accounts • Flexible PTO • 401(k) + Company Match • Life Insurance • Pet insurance • Flat organizational structure • Autonomy, Competence and Belonging-focused work culture