Compliance Manager

Job Summary

To support a mission-driven healthcare organization, the remote Manager, Compliance will develop and oversee the enterprise-wide Fraud, Waste, and Abuse (FWA) Prevention Program, ensuring compliance with regulatory requirements while collaborating with various teams to implement corrective action plans and training initiatives.

Key responsibilities

• Lead the development, coordination, and oversight of the FWA Prevention Program, including prevention, detection, and resolution of potential FWA
• Partner with operational leadership to ensure compliance with federal and state program integrity requirements and industry best practices
• Provide subject-matter expertise and guidance on regulatory compliance matters, and develop training programs for team members at all levels

Required qualifications

• Bachelor's degree in healthcare administration, business administration, law, compliance, or a related field required
• Advanced degree or professional certification such as Certified in Healthcare Compliance (CHC) or Certified Fraud Examiner (CFE) preferred
• Minimum of five years of experience in healthcare compliance, program integrity, or fraud investigation oversight
• In-depth knowledge of federal and state Medicare and Medicaid FWA regulations
• Experience leading complex investigations, including data analysis and reporting