Compliance Manager Reports to: Chief Executive Officer /
Project Director Status:
Full-Time |
Exempt Summary:
Leads NeighborHub Health's organization-wide compliance program and serves as a primary compliance resource to the Chief Executive Officer, leadership team, and Board. The Compliance Manager is responsible for monitoring regulatory requirements, conducting compliance reviews and investigations, coordinating corrective actions, maintaining compliance policies and education, and helping ensure the organization is prepared for HRSA, payer, grant, privacy, and other healthcare compliance requirements.
Responsibilities:
Lead the day-to-day operation of the organization's compliance program, including the annual compliance work plan, priorities, monitoring activities, and corrective-action tracking. Serve as a trusted compliance advisor to the CEO and leadership team and provide clear, practical guidance on regulatory, ethical, and operational compliance matters. Maintain current knowledge of HRSA Health Center Program requirements, HHS-OIG compliance guidance, Medicare and Medicaid requirements, federal grant requirements, HIPAA/privacy requirements, and other federal, state, and local healthcare regulations applicable to NeighborHub Health. Conduct periodic compliance risk assessments and use findings to establish monitoring, auditing, training, and policy priorities. Develop and perform compliance monitoring and audits; document findings, identify root causes, recommend corrective actions, and track remediation through completion. Receive, assess, and investigate reported compliance concerns involving suspected violations of law, regulation, policy, billing requirements, privacy standards, conflicts of interest, fraud, waste, abuse, or other compliance matters. Maintain confidential reporting channels and support a culture in which employees may raise compliance concerns without retaliation. Develop, maintain, and coordinate review of the Code of Conduct and compliance-related policies and procedures; ensure required reviews and approvals occur on schedule. Plan and coordinate required compliance education for employees, providers, leaders, and Board members; partner with Human Resources to assign, communicate, document, and track required training. Partner with Human Resources on compliance matters involving employee conduct, confidentiality, retaliation, policy violations, investigations, and corrective-action follow-up while HR retains responsibility for employee relations, discipline, and other employment decisions. Coordinate compliance readiness for HRSA Operational Site Visits, grant reviews, payer audits, government inquiries, and other external reviews; organize documentation and track findings or conditions through resolution. Monitor exclusion, sanction, licensing, and other required compliance screening processes for employees, providers, contractors, and vendors, and ensure identified issues are appropriately escalated. Review business practices, contracts, arrangements, and organizational initiatives for potential compliance concerns and coordinate with leadership, Finance, HR, clinical leaders, external counsel, or other subject-matter experts as needed. Prepare regular compliance reports, dashboards, trends, and recommendations for the CEO and Board or designated Board committee, including significant findings, investigations, corrective actions, training, and monitoring activity. Support appropriate response to potential overpayments, billing/coding concerns, privacy matters, conflicts of interest, fraud and abuse concerns, and other compliance issues, including timely escalation and coordination with legal counsel when appropriate. Promote consistent documentation, accountability, ethical conduct, and compliance awareness across departments and perform other compliance duties consistent with the position and organizational needs.
Education & Experience:
Bachelor's degree in healthcare administration, compliance, business administration, public health, law, finance, nursing, or a related field required; master's degree, JD, or comparable advanced education preferred. Minimum of five (5) years of progressively responsible healthcare compliance experience required; seven (7) or more years or prior responsibility for a substantial compliance program strongly preferred. Demonstrated experience conducting compliance audits, investigations, risk assessments, regulatory analysis, and corrective-action follow-up required. Working knowledge of healthcare fraud and abuse laws, federal healthcare program requirements, HIPAA/privacy requirements, and healthcare compliance program standards required. Experience with HRSA Health Center Program requirements, FQHC operations, federal grants, Operational Site Visits, or community health center compliance strongly preferred. Experience preparing compliance reports for senior leadership, Boards, or Board committees and communicating complex requirements to non-compliance audiences preferred. Experience developing policies, compliance education, monitoring plans, and confidential reporting or investigation processes required. Healthcare compliance certification such as CHC, CHPC, CCEP, CPCO, or comparable credential preferred. Strong judgment, independence, discretion, objectivity, analytical ability, and ability to handle confidential and sensitive matters. Strong written and verbal communication skills with the ability to influence, advise, and work effectively with executive leadership, HR, Finance, clinical leaders, and employees across the organization. Demonstrated ability to manage multiple priorities, maintain documentation, meet regulatory deadlines, and follow complex matters through resolution. Commitment to NeighborHub Health's mission and to serving people experiencing homelessness, people living with HIV, and other medically underserved or vulnerable populations.
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Parental leave Retirement plan Vision insurance