Manager, Compliance - Remote

Lensa; Saint Paul (MN); Remote; USD 90,000 - 120,000; Full time

Job summary

A leading company is seeking a Compliance Manager to oversee compliance initiatives and ensure adherence to regulations. The role involves collaboration with various departments, executing compliance procedures, and providing leadership to compliance professionals. Ideal candidates will have significant experience in legal or compliance roles within healthcare and possess strong communication and problem-solving skills.

Qualifications

• 6 years of experience in legal or compliance roles within healthcare or a highly regulated industry.
• Experience with Medicare, Medicaid, and ACA.

Responsibilities

• Execute compliance procedures and enforce policy governance across the organization.
• Support the prompt investigation of compliance-related issues with Legal and HR.
• Develop and track metrics to assist leadership in compliance reporting.

Skills

Communication

Critical Thinking

Problem Solving

Organizational Skills

Education

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

HS diploma or GED

Job description

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

• Execute compliance procedures and enforce policy governance across the organization and assigned functions to validate regulatory reporting requirements are met and that business operations are aligned with applicable regulatory guidance. Design, develop, implement, conduct, and maintain effective compliance, risk assessment, vendor, and ethics awareness processes, audits, work plans, and communications based on business needs and risk ranking methodology.
• Support the prompt and thorough investigation of reported compliance-related issues, partnering with Legal and HR as appropriate.
• Represent the compliance organization and, at times, Prime as a primary contact on contracts or significant enterprise projects; collaborate with and represent the interests of key internal and external stakeholders.
• Serve as a consultant to management on major policies, plans, and objectives, providing Subject Matter Expertise in focus areas such as ACA, Medicare, Medicaid, and Corporate Compliance.
• Develop and track metrics to assist leadership in preparing reports demonstrating the effectiveness of compliance functions.
• Manage the preparation, implementation, and maintenance of compliance standards and procedures, and review applicable documentation; develop strategies for regulatory change management.
• Provide leadership to compliance professionals, role modeling Prime’s employee and leadership expectations.
• Support audit and corrective action plans for designated areas; design remedies and support implementation and tracking.
• Evaluate compliance training needs and develop training programs; manage conflict of interest and code of conduct programs if applicable.
• Perform 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 experience in legal or compliance roles within healthcare, PBM, or a highly regulated industry, including experience with Medicare, Medicaid, and ACA.
• Must be eligible to work in the U.S. without sponsorship.

Additional Qualifications

• Excellent written and oral communication skills.
• Critical thinking and problem-solving skills for complex compliance issues.
• Experience in developing and delivering enterprise training programs.
• Deep knowledge of compliance principles, standards, and industry best practices.
• Ability to interpret and present complex information effectively.
• Strong organizational skills and ability to manage multiple projects.

Preferred Qualifications

• Certified Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC).
• Experience in healthcare, health insurance, or PBM sectors.
• Advanced degree such as JD, MHA, or MPA.
• Leadership experience.

Minimum Physical Job Requirements

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

Reporting Structure

• Reports to Director or Senior Director in the Compliance department.