Compliance System Administrator and Investigator

Talentcare, LLC; Indianapolis (IN); Remote; USD 70,000 - 100,000; Full time

Job summary

Hopebridge in Indianapolis, IN is hiring a Compliance System Administrator and Investigator to manage the compliance intake system and investigate policy violations reported through a hotline or other channels.

You will configure the case management platform, input investigations, analyze evidence, interview stakeholders, and prepare detailed reports. You will collaborate with HR, Legal, and Operations to implement corrective actions where needed.

Qualifications

• Bachelor’s in Healthcare-related field.
• Certification in healthcare compliance (CHC) preferred.
• Prior experience investigating compliance concerns.
• Proficient Microsoft Office skills.
• Experience administering or using a compliance case management/intake system (e.g., Healthicity, NAVEX, Convercent, EthicsPoint).
• Proficient in data analytics and visualization tools (Excel, Power BI, Tableau) to support reporting.

Responsibilities

• Conduct impartial investigations of incidents, collaborating with Legal Counsel and senior staff.
• Receive confidential questions/concerns from employees and caregivers and triage accordingly.
• Investigate inquiries via email, voicemail, or hotline and provide recommendations or escalate.
• Respond to reports of alleged Fraud, Waste, Abuse, HIPAA violations, and sentinel events with thorough investigations.
• Plan and conduct confidential investigations; interview involved parties; gather and secure documentation; analyze data and develop recommendations.
• Provide detailed reports of findings in line with policy and applicable regulations.

Skills

Problem Solving

Communication

Attention to Detail

Self-Management

Data Analytics

Education

Bachelor’s in Healthcare-related field

CHC certification (preferred)

Tools

Excel

Power BI

Tableau

Job description

Compliance System Administrator and Investigator

Indianapolis, IN

Hopebridge

Job Summary

As a Compliance Investigator and system administrator, you will be responsible for receiving, evaluating, triaging investigations or complaints brought to Hopebridge’s attention through a hotline, individual or group who believe that there has been a violation of policy or process.

You will need experience managing and customizing a compliance system to input investigations and track for resolution. As part of the investigation process, you will need experience in analyzing evidence, speaking to complainants and NHS/other government departments, and liaise with internal HR, Clinical, and Operational leaders to reach decisions on whether to uphold complaints. High-level responsibilities include but are not limited to reviewing and identifying complaint trends and issues, organizing and leading investigations associated with various allegations and assisting in the development of action plans for substantiated allegations. This position also requires the ability to take the data from the investigation system and track/trend in presentations for executive leadership.

Job Responsibilities

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Conductimpartialinvestigationsofincidents,inclosecollaborationwithLegalCounselandother senior level staff.
• Receiveconfidentialquestions/concernsfromemployees,parents/guardiansandcommunity concerning compliance situations.
• Investigatequestions/concernsreceivedbyemail,voicemail,drop-ins,compliancehotline,etc. to determine specifics and provide recommendations for resolution or refer concern to appropriate individual(s) for additional investigation/follow-up.
• Respond to reports of incidents alleging Fraud, Waste, Abuse, HIPAA, and sentinel events in a thoroughmannerand,whennecessary,conductinvestigations;maintainclearcommunication with all involved parties.
• Planandconductconfidentialinvestigationsofincidentsandcomplaints;identifyandconduct interviews with all involved parties, gather and secure relevant documentation; analyze data, compare incident reports to legal standards and policies, and develop recommendations to address and resolve issues.
• Provide a detailed report summarizing the investigation/findings of the investigation, in accordance with company policy,and when applicable, local, state and federal rulesand regulations.
• Consultwithregionalpersonneloncreatingandmaintaininganequalopportunityenvironment and the interpretation and consistent application of local, state, and federal rules, regulations and policies.
• Workcollaboratively with HR and other departments, for appropriate follow-upafter report summariesandfindingsofinvestigation(s)arecompletedtodocumentcorrectiveactionand potential resolution.
• Assistclinicsandassociatedregionalteammemberswithincidentsandinvestigationsregarding bullying.
• Assistinresearchanddevelopmentoftrainingrelatedtoallaspectsofcompliance;identify training needs and implement broad-based and customized training across all levels of employees and students on compliance topics.
• Plan and conduct compliance monitoring reviews; verify documentation to support certified monitoringplanswhereapplicable;developrecommendationsforcorrectiveactionbasedon findings.
• Follow-upandmonitortoverifythatcorrectiveactionshavebeenimplemented.
• Analyzeexistingpolicies,identifygaps,andrecommendnew/revisedpolicies,procedures,and approval processes.
• ServeastheprimarysystemadministratorforHopebridge’scomplianceintakesystem(hotline andcasemanagementplatform),includingmanaginguseraccessandpermissions,configuring intake workflows and case routing rules, and maintaining system settings to ensure accurate and timely case handling.
• Monitorthecomplianceintakesystem’sperformanceanddataintegrity;troubleshootissues, coordinatewithITandthird-partyvendorstoresolvetechnicalproblems,andleadorsupport system upgrades, enhancements, and user acceptance testing.
• Develop,maintain,anddistributedashboards,scorecards,andreportsusingdataanalyticstools to track key compliance metrics, including case volume, case type, source, resolution timeframes, and outcomes.
• Analyzeintakeandinvestigationdatatoidentifytrends,patterns,andemergingriskareasacross the organization; translate findings into actionable insights and recommendations for compliance leadership.
• Safeguardthesecurity,confidentiality,andintegrityofalldatahousedwithinthecompliance intake system, in accordance with HIPAA and Hopebridge data governance policies.
• Support internal and external audits of the intake system’s data, controls, and reporting processes,andmaintainup-to-datesystemdocumentation,userguides,andstandardoperating procedures.
• Performvariousadministrativefunctions:processestransactionalinformation;performdata entry and record updates for employee tracking, records maintenance, and database management.
• Prepare correspondence and memorandums; maintain files, forms, documentation and informationinaccordancewithpoliciesandprocedures;performspecialprojectsasdirected and prepare reports as required.
• FollowandpromoteHopebridge’smissionandprioritiesincompliancewithallpoliciesand procedures.
• Reviewcontractsforcompliancewithdistrictrequirements.
• Performotherdutiesasassigned.
• Attends and participates in required educational training sessions and staff meetingsas scheduled and assigned
• Completesallassignedmandatorytrainingmodules.
• Followsallstateandfederallaws,includingHIPAA.
• Maintain a clear criminal record

Required Skills & Qualifications

• ProblemSolvingandAnalyticalSkills
• GoodCommunication-VerbalandWritten
• AttentiontoDetail
• Self-Management
• DataAnalysis,Reporting,andSystemsProficiency

Required Education and Experience

• ABachelor’sinHealthcarerelatedfield
• Prioritygiventoindividualswithacertificationinhealthcarecompliance(CHC)
• Priorexperienceinvestigatingcomplianceconcerns.
• ProficientknowledgeofMicrosoftOfficeSuite.
• Experienceadministeringorutilizingacompliancecasemanagement/intakesystem(e.g., Healthicity, NAVEX, Convercent, EthicsPoint, or similar platform) preferred.
• Proficientindataanalyticsandvisualizationtools(e.g.,Excel,PowerBI,Tableau)tosupport compliance reporting and trend analysis.

Position Type/Expected Hours of Work

This is a full-time position,Monday through Friday.

Physical Demands

Prolonged periodssitting at a desk and working on a computer.

Work is performed in a remotehome environment.

Other Duties

Please note this job description is not designedto cover or contain a comprehensive listingof activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Disclaimer

The above statements reflect general functions of this job and shall not be construed as a detailed descriptionofallworkrequirementsinherentinthisjob.Theimmediatesupervisormayelaborateonor add to the above list if the duties come within the employee’s realm of responsibility.

Hopebridge is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status,veteran status, sexualorientation, arrest recordor any other characteristic protected by applicable federal, state or local laws.