Compliance Manager

Pediatric Home Service, Inc.; Alaska; Remote; USD 70,000 - 90,000; Full time

Job summary

Pediatric Home Service is seeking a Compliance Manager to oversee compliance in the healthcare sector. This role includes managing audits, ensuring regulatory adherence, and developing compliance policies while overseeing a dedicated team. A Bachelor's degree with relevant experience is required for this pivotal position in pediatric care.

Benefits

Generous Paid Time Off (PTO)

401(k) Matching

Tuition Reimbursement

Professional Development & Learning Opportunities

Supportive work environment

Qualifications

• 3–5 years of progressive experience in healthcare compliance.
• At least 2 years in a PPEC, home health, or pediatric long-term care setting.
• Experience coordinating with Medicaid audits.

Responsibilities

• Lead development and oversight of compliance programs.
• Manage audits and credentialing activities.
• Communicate regulatory changes to stakeholders.

Skills

Leadership

Analytical Skills

Auditing

Communication

Education

Bachelor’s degree in healthcare administration, nursing, health information management, or a related field.

Tools

EMR systems

Excel

Job description

At PHS, we help medically complex kids live their best lives—at home, with their families. As a national leader in pediatric home care, we offer a full range of services including infusion, clinical nutrition, respiratory therapy, PPEC, private duty nursing, and DME.

Whether you're caring for patients or supporting behind the scenes, every role at PHS makes a difference. Join a mission-driven team that’s committed to putting children and families first.

• Position: Compliance Manager
• Location: Florida
• Hours: Monday-Friday,(8a-5p)
  • fully remote

Position Summary

The Compliance Manager leads the development, implementation, and oversight of a robust compliance program across assigned region(s). This role ensures the organization meets all federal, state, and local regulatory requirements, with a focus on audit preparedness, documentation accuracy, and credentialing. The Compliance Manager plays a key role in promoting a culture of accountability, integrity, and continuous improvement to support high-quality, patient-centered care.

Key Responsibilities

Conduct and manage audits to ensure documentation supports claims submitted to government and commercial payers.

Oversee credentialing activities including Medicare/Medicaid revalidations, license renewals, and accreditation submissions.

Develop, implement, and maintain compliance policies and procedures in alignment with payer guidelines and regulations.

Analyze payer contracts and fee schedules; report changes and implications to leadership.

Identify trends, risks, and opportunities from audits and credentialing data to drive proactive improvements.

Develop and execute audits aligned with the annual Compliance Work Plan.

Conduct follow-up audits to confirm resolution of compliance issues.

Stay current on relevant regulatory changes and communicate key updates to internal teams.

Prepare and deliver compliance reports and trainings for internal stakeholders.

Participate in relevant committee meetings and support compliance standards development.

Supervisory Duties

Supervise and support assigned team members.

Responsibilities include hiring, training, assigning tasks, conducting performance evaluations, and addressing employee relations matters.

Qualifications

Education & Experience:

• Bachelor’s degree required in healthcare administration, nursing, health information management, or a related field.
• 3–5 years of progressive experience in healthcare compliance, with at least 2 years in a PPEC, home health, or pediatric long-term care setting.
  

Preferred:

• Certified Coder (CPC, CCS-P, or equivalent).
• CHC (Certified in Healthcare Compliance) or similar compliance certification.
• Experience coordinating or responding to Medicaid audits or Agency Plan of Correction (POC) follow-ups.
• Experience using EMR systems
• Advanced skills in Excel for data analysis, tracking audit outcomes, and compliance monitoring.
• Prior involvement in mock surveys, accreditation preparation (ACHC, CHAP, or Joint Commission), or internal readiness reviews.
• Deep understanding of CMS guidelines, Medicaid managed care plans, and state-specific regulations for home care and PPEC operations.
• Proven experience working with Health Care Administration (AHCA), including licensing, inspections, and compliance responses.
• Experience managing credentialing and licensing for home care providers and facilities.

THE COMPANY:

Pediatric Home Service is a pediatric home health agency that has provided high-quality DME and nursing services to medically fragile children since 1990. Our services allow our clients to remain and thrive in their homes, schools, and communities. The majority of the clients we serve are age’s birth through 21 years old and have a variety of technologies that might include a trach, ventilator or g-tube.

BENEFITS:

• Generous Paid Time Off (PTO) for full time employees to ensure a healthy work-life balance
• 401(k) Matching to help secure your future
• Tuition Reimbursement to support your educational and professional growth
• Professional Development & Learning Opportunities to expand your skills and knowledge in pediatric care
• A supportive and fulfilling work environment where your contributions directly impact children’s health and well-being

We look forward to learning more about you and the skills you can bring to Pediatric Home Service!

Pediatric Home Service is an equal opportunity employer; we are committed to affirmative action and equal employment opportunities for all regardless of protected veteran status, race, color, creed, religion, national origin, sex, sexual orientation or identity, disability, age, marital status, familial status, membership or activity in a local human rights commission, or status with regard to public assistance. #DME123