Manager, Compliance - Remote

Lensa; Madison (WI); Remote; USD 80,000 - 110,000; Full time

Job summary

An established industry player is seeking a Compliance Manager to lead compliance initiatives and foster a culture of compliance. This remote position involves working closely with internal stakeholders to interpret laws and regulations, manage compliance programs, and provide expert guidance on compliance matters. The ideal candidate will possess exceptional communication skills and a strong background in healthcare compliance. Join a team dedicated to making a positive impact on healthcare services and ensuring adherence to regulatory standards.

Qualifications

• 6 years of progressive experience in legal or compliance roles within healthcare.
• Experience developing and delivering enterprise training programs.

Responsibilities

• Executes compliance procedures and enforces policy governance across the organization.
• Supports the prompt and thorough investigation of compliance-related issues.
• Develops and tracks metrics to assist leadership in preparing compliance reports.

Skills

Exceptional communication skills

Critical thinking

Problem-solving

Interpersonal skills

Organizational skills

Education

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

HS diploma or GED

Job description

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Job Posting Title

Manager, Compliance - Remote

Job Description

The Compliance Manager works closely with designated business areas, Legal, and other internal partners to identify changing laws and regulations, accreditation standards, and client contractual compliance obligations, interpret the impact, and manage solutions for designated business areas. This position serves as a consultant to internal stakeholders regarding the development, implementation and monitoring of compliance initiatives and helps to create a culture of compliance throughout the organization.

Responsibilities

• Executes compliance procedures and enforces policy governance across the organization and assigned function to validate regulatory reporting requirements are met and that business operations are aligned with applicable regulatory guidance. Designs, develops, implements, conducts and maintains effective compliance, risk, assessment, vendor and ethics awareness processes, audits, work plans and communications based on business need and risk ranking methodology.
• Supports the prompt and thorough investigation of reported compliance-related issues, partnering with Legal and HR as appropriate.
• Represents the compliance organization and at times, Prime, as a primary contact on contracts or significant enterprise projects; collaborates with and represents the interests of key internal and external stakeholders.
• Serves as a consultant to management on major matters pertaining to policies, plans and objectives and provides Subject Matter Expertise in areas such as ACA, Medicare, Medicaid, Corporate Compliance, and Compliance Assessment or Services.
• Develops and tracks useful metrics to assist leadership in preparing periodic reports demonstrating effectiveness of the compliance function.
• Manages the preparation, implementation and maintenance of compliance standards and procedures (e.g., SOPs, Desk Top Procedures), reviews applicable documentation, and develops regulatory monitoring and response strategies for changes or new laws to support compliance efforts.
• Provides leadership to other compliance professionals, role modeling Prime’s employee and leadership expectations.
• May oversee and support audit and corrective action plans, designing remedies and supporting implementation, tracking, and completion.
• Evaluates compliance training needs and develops and implements training programs to foster a culture of compliance. May also manage conflict of interest and code of conduct programs.
• Performs other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in business, healthcare, or related field, or equivalent experience; HS diploma or GED required.
• 6 years of progressive experience in legal or compliance roles within healthcare or regulated industries, including Medicare, Medicaid, and ACA.
• Must be eligible to work in the U.S. without sponsorship.

Additional Qualifications

• Exceptional communication skills.
• Critical thinking and problem-solving abilities in complex compliance situations.
• Experience developing and delivering enterprise training programs.
• Expertise in compliance program principles, standards, and best practices.
• Ability to interpret and present complex information effectively.
• Strong interpersonal skills to influence at all levels.
• Organizational skills to manage multiple projects.

Preferred Qualifications

• Certifications such as CCEP or CHC.
• Experience in healthcare, health insurance, or PBM sectors.
• Advanced degrees like JD, MHA, MPA.
• Leadership experience.

Minimum Physical Job Requirements

• Travel up to 20%.
• Constantly sit, handle, talk, hear.
• Frequently reach with hands and arms.
• Occasionally stand, walk, stoop, kneel, crouch.
• Occasionally lift/move up to 10-25 pounds.
• Specific vision abilities required.

Reporting Structure

• Reports to Director or Senior Director in Compliance.