Compliance Manager

Medical Guardian

Philadelphia (Philadelphia County)

Hybrid

USD 120,000 - 160,000

Full time

14 days+

A complete application in a minute

Tailored resume and cover letter, ready to send.

Get past ATS filters

Benefits offered by this job

Health Plan (Medical, Dental & Vision)

Paid Time Off

Company Paid Short Term Disability and

Retirement Plan (401k) with Company匹

Job summary

Medical Guardian's MedScope unit seeks a Senior Compliance Manager to lead the design and oversight of our compliance program across Medicaid, Medicare, HIPAA, and related regulations. You will build policies, training, and controls to mitigate risk while promoting accountability.

The role requires a proven track record in healthcare compliance, multi-state experience, and collaboration with legal, IT, and operations to implement effective CAPs and ensure privacy and security of PHI.

Qualifications

Bachelor’s degree in healthcare administration, business, law, or related field.
7+ years of healthcare compliance experience focusing on Medicaid, Medicare, and HIPAA.
Experience auditing, monitoring, and risk management in a healthcare environment.
Experience managing compliance across multiple states and translating regulations into policies.

Responsibilities

Develop and maintain a comprehensive compliance program meeting Medicaid, Medicare, and HIPAA requirements.
Update policies and procedures to reflect regulatory changes.
Create a compliance framework with training, documentation, monitoring, and enforcement.
Coordinate multi-state compliance activities and address differences in state regs.
Monitor state laws and implement changes timely.
Develop and execute internal audit plans and oversee CAPs.
Oversee HIPAA privacy and security and PHI handling.
Provide ongoing staff training on Medicaid, Medicare, HIPAA.

Skills

HIPAA compliance

Regulatory auditing

Risk management

Cross-functional leadership

Training & education

Policy development

Project management

Background screening policies

Education

Bachelor’s degree in healthcare administration, business, law, or related field

Master’s degree or CHC/CCEP certification (plus)

Tools

MS Office

Compliance software tools

Job description

About Medical Guardian:

Medical Guardian is a fast-growing digital health and safety company on a mission to help people live a life without limits. With 14 consecutive years on the Inc. 5000 list of Fastest Growing Companies, we are redefining what it means to age confidently and independently.

We support over625,000 membersnationwide with life-saving emergency response systems and remote patient monitoring solutions. Trusted by families, healthcare providers, and care managers, our work is powered by a culture of innovation, compassion, and purpose.

Position Overview

MedScope, a Medical Guardian Company, is seeking a Senior Compliance Manager to play a pivotal role in safeguarding the integrity and long-term success of our operations. This role is essential in ensuring adherence to state and federal healthcare regulatory requirements, particularly in Medicaid, Medicare, HIPAA, and healthcare compliance enforcement. The Compliance Manager will design, implement, and oversee a robust compliance program, mitigating risk while fostering a culture of accountability, ethical behavior, and regulatory excellence.

The ideal candidate brings expertise in healthcare compliance, familiarity with personal emergency response systems (PERS), and a proactive approach to problem-solving. This position offers an opportunity to drive impactful change across a growing organization.

Key Responsibilities

1. Compliance Program Development & Management

Design, implement, and maintain a comprehensive compliance program that meets state and federal requirements, including Medicaid, Medicare, and HIPAA regulations.
Develop and continuously update policies and procedures to reflect regulatory changes.
Create a compliance framework, integrating training, documentation, monitoring, and enforcement mechanisms.
Oversee and support compliance activities across multiple states, identifying and addressing differences in federal, state, and local regulatory requirements.
Monitor changes in state-specific laws, regulations, and agency guidance; assess operational impact and coordinate timely implementation.

2. Internal Audit & Risk Management

Develop and execute internal audit plans to assess compliance with applicable regulations.
Proactively identify compliance risks, conduct assessments, and recommend effective corrective actions.
Lead the management and oversight of Corrective Action Plans (CAPs) to address identified gaps and ensure timely resolution.

3. HIPAA & Regulatory Compliance Oversight

Ensure company-wide adherence to HIPAA privacy and security standards related to Protected Health Information (PHI).
Monitor activities to identify potential violations, initiate investigations, and enforce corrective actions where necessary.
Collaborate with IT and operations teams to ensure compliance with PERS-related healthcare systems and technology.

4. Training & Education

Provide ongoing training for employees at all levels, ensuring understanding of compliance policies, ethical standards, and regulatory updates.
Serve as a subject matter expert, educating internal stakeholders—including executive leadership—on Medicaid, Medicare, and HIPAA requirements.

5. Cross-Functional Collaboration & Project Leadership

Lead compliance-driven projects, ensuring regulatory requirements are integrated into product launches, IT implementations, and organizational processes.
Partner with legal, operations, and IT teams to ensure compliance across new initiatives and contracts.
Foster clear communication of compliance requirements and objectives across all departments.
Develop and maintain policies, procedures, controls, and documentation for employee background screening and fingerprinting processes.

6. Documentation & Reporting

Maintain comprehensive compliance documentation, including policies, audit results, risk assessments, and corrective action plans.
Prepare regular compliance reports for executive leadership, detailing activities, findings, and progress.

7. Other Duties as Assigned

Required Qualifications Education & Experience

Bachelor’s degree in healthcare administration, Business, Law, or a related field (Master’s degree or relevant certifications like CHC, CCEP, a plus).
Minimum of 7 years of experience in healthcare compliance, with a focus on Medicaid, Medicare, and HIPAA regulations.
Demonstrated experience in auditing, monitoring, and risk management within a healthcare environment.
Demonstrated experience managing compliance requirements across multiple states, including interpreting state-specific regulations and translating them into operational policies and procedures.

Skills & Knowledge

Strong understanding of state and federal Medicaid/Medicare programs, HIPAA regulations, and healthcare compliance enforcement.
Experience with personal emergency response systems (PERS) and healthcare IT compliance.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and compliance software tools.
Exceptional project management skills, with the ability to manage multiple initiatives simultaneously.
Excellent verbal and written communication skills, with the ability to educate and influence stakeholders at all organizational levels.
Strong analytical skills with the ability to assess complex regulations and identify actionable solutions.
Working knowledge of employee background-screening requirements, including criminal background checks, fingerprinting, consent and disclosure requirements, and appropriate handling of screening results.

Personal Attributes

High ethical standards, confidentiality, and a strong commitment to compliance integrity.
Proactive problem-solving mindset and ability to work independently under tight deadlines.
Thrives in a dynamic, fast-paced environment with a focus on delivering results