Manager, Compliance - Remote

Lensa; Salt Lake City (UT); Remote; USD 80,000 - 110,000; Full time

Job summary

An established industry player is seeking a Compliance Manager to lead compliance initiatives in a dynamic environment. This remote role involves working closely with internal teams to ensure adherence to regulations and standards. The ideal candidate will have a strong background in healthcare compliance, exceptional communication skills, and the ability to influence at all organizational levels. Join a team that values integrity and compliance, where your contributions can make a significant impact on the organization’s success. If you are passionate about compliance and eager to drive positive change, this opportunity is perfect for you.

Qualifications

• 6 years of experience in compliance roles within healthcare.
• Ability to interpret complex regulations and develop training programs.

Responsibilities

• Execute compliance procedures and enforce policy governance.
• Support investigations of compliance issues with Legal and HR.
• Develop and track metrics for compliance effectiveness.

Skills

Compliance Management

Legal Knowledge (Medicare, Medicaid, ACA)

Communication Skills

Critical Thinking

Project Management

Education

Bachelor’s degree in business or healthcare

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. They 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 to meet regulatory reporting requirements and align business operations with applicable guidance. Design, develop, implement, and maintain effective compliance, risk, assessment, vendor, and ethics awareness processes, audits, work plans, and communications based on business need and risk ranking methodology.
• Support the investigation of reported compliance issues, partnering with Legal and HR as appropriate.
• Represent the compliance organization and Prime in contracts or significant enterprise projects; collaborate with and represent the interests of key internal and external stakeholders.
• Serve as a consultant to management on policies, plans, and objectives, providing Subject Matter Expertise in areas like ACA, Medicare, Medicaid, and Corporate Compliance.
• Develop and track metrics to assist leadership in reporting the effectiveness of the compliance function.
• Manage the development, implementation, and maintenance of compliance standards and procedures. Review operations documentation and develop monitoring and response strategies for regulatory changes.
• Provide leadership to compliance professionals, role modeling Prime’s expectations.
• Oversee audit and corrective action plans, supporting the business in their implementation.
• Evaluate compliance training needs and develop training programs; may also manage conflict of interest and code of conduct programs.
• 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 progressive experience in legal or compliance roles within healthcare or a highly regulated industry, including experience with Medicare, Medicaid, and ACA.
• Legal authorization to work in the U.S. without sponsorship.

Additional Qualifications

• Exceptional communication skills.
• Critical thinking skills for complex compliance issues.
• Experience developing and delivering enterprise training programs.
• Expertise in compliance program principles and industry standards.
• Ability to interpret and present complex information effectively.
• Ability to influence at all organizational levels.
• Strong organizational skills for managing multiple projects.

Preferred Qualifications

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

Minimum Physical Job Requirements

• Travel up to 20%.
• Constantly sit, use hands, talk, hear; frequently reach; occasionally stand, walk, stoop, kneel, crouch; lift up to 25 pounds.
• Vision abilities include close, distance, color, peripheral, depth perception, and focus adjustment.

Reporting Structure

• Reports to Director or Senior Director in Compliance.

Every employee must understand and comply with security responsibilities and all legal, regulatory, and internal policies.