Compliance Manager

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.

Benefits

• Health Care Plan (Medical, Dental & Vision)
• Paid Time Off (Vacation, Sick Time Off & Holidays)
• Company Paid Short Term Disability and Life Insurance
• Retirement Plan (401k) with Company Match