Compliance Manager

Medical Guardian; Philadelphia (Philadelphia County); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

Health care plan

Job summary

Medical Guardian is seeking a Compliance Manager to design, implement, and oversee a comprehensive regulatory program across Medicaid, Medicare, HIPAA, and healthcare enforcement. The role requires strong auditing, risk management, and cross-functional leadership to safeguard operations and drive ethical practices.

The candidate should bring 5+ years in healthcare compliance, familiarity with PERS, and ability to educate executives on complex rules while partnering with legal, IT, and operations.

Qualifications

• Bachelor's degree or higher with healthcare/regulatory focus.
• Master's degree or relevant certifications are a plus.
• Minimum 5 years in healthcare compliance and regulatory enforcement.

Responsibilities

• Develop and maintain a comprehensive compliance program aligned with Medicaid, Medicare and HIPAA.

Skills

Medicaid/Medicare

HIPAA compliance

PERS familiarity

IT compliance

MS Office

Compliance software

Project management

Communication skills

Analytical skills

Education

Bachelor's degree in healthcare administration,Business, Law, or related field

Master's degree or CHC/CCEP certification

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 over 625,000 members nationwide 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 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.
• 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.
• 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 5 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.
• 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.
• 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
• Health Care Plan (Medical, Dental & Vision) Pa