Company Overview:

Calibrated Healthcare is a specialized healthcare Business Process Outsourcing (BPO) company providing operational, administrative, and consulting services to Health Plans, IPA, MSOs and Medical Group. Our services support core healthcare administrative functions including utilization management, claims administration, compliance, credentialing, and quality management. Headquartered in Ontario, California, Calibrated Healthcare operates globally with offices in the United States, India, and the Philippines. We support healthcare organizations across California and nationally with scalable operational infrastructure designed to meet regulatory, compliance, and performance requirements.

Position Overview:

Calibrated Healthcare is seeking an experienced, hands-on Compliance Manager to manage and support the company's healthcare compliance program across our U.S. and offshore operations. This position will be responsible for maintaining Calibrated's compliance policies and procedures, managing PHI/privacy and compliance incidents, investigating and documenting escalations, preparing client responses, coordinating corrective actions, supporting audits, and ensuring compliance matters are properly followed through to closure. We are looking for someone who takes ownership of all compliance matters from beginning to end. The ideal candidate can independently investigate an issue, gather the facts, document findings, determine appropriate next steps, coordinate with internal departments, prepare a professional client response, and ensure corrective actions are completed. This is not solely a policy-writing or audit position. The Compliance Manager will be actively involved in the day-to-day compliance needs of a growing healthcare organization.

Key Responsibilities:

• Maintain and update Calibrated's compliance policies, procedures, Code of Conduct, privacy policies, and related compliance documentation.
• Ensure policies remain aligned with applicable regulatory, contractual, client, and operational requirements.
• Develop practical compliance workflows and procedures that employees and operational teams can follow.
• Maintain appropriate policy approvals, revisions, employee acknowledgments, and supporting documentation.
• Manage suspected or confirmed PHI, HIPAA, privacy, and compliance incidents.
• Ensure incidents are promptly reported, documented, investigated, escalated, and tracked through final resolution.
• Gather information and supporting documentation from employees, management, IT, Information Security, HR, Operations, and other departments.
• Maintain complete incident documentation, including dates, individuals involved, findings, root cause, corrective actions, client communications, and final closure.
• Coordinate with the CISO/Information Security and legal counsel when technical investigation, breach assessment, legal interpretation, or regulatory review is required.
• Serve as a primary point of contact for compliance-related client inquiries and escalations.
• Coordinate internal investigations and ensure the appropriate departments provide the information necessary to resolve the issue.
• Prepare clear, accurate, professional written responses to clients regarding compliance incidents, findings, corrective actions, and resolution.
• Ensure statements made to clients are supported by appropriate documentation.
• Maintain ownership and follow-up of compliance matters until the issue has been fully addressed and documented as closed.
• Conduct or coordinate compliance investigations and document findings.
• Perform root-cause analysis and determine whether an incident represents an isolated event or a broader process or control weakness.
• Develop and track Corrective Action Plans (CAPs) when appropriate.
• Verify that corrective actions have been implemented rather than simply documenting that they were assigned.
• Identify recurring compliance issues and recommend improvements to policies, workflows, systems, training, or operational controls.
• Support client audits, compliance reviews, privacy and security assessments, delegation reviews, and other healthcare compliance activities.
• Coordinate responses to compliance questionnaires, attestations, and documentation requests.
• Maintain organized compliance evidence so requested information can be produced timely during audits and client reviews.
• Track audit findings and corrective actions through completion.
• Support healthcare regulatory and contractual requirements applicable to Calibrated's services, including HIPAA and delegated healthcare operations.
• Coordinate required HIPAA, privacy, security, Code of Conduct, Fraud, Waste, and Abuse, and other compliance training.
• Track completion and follow up on outstanding requirements.
• Develop targeted compliance education or employee reminders when incidents or audit findings identify a need for additional training.
• Partner with Human Resources and operational leadership when employee counseling, retraining, or corrective action may be appropriate.
• Maintain centralized logs for PHI/privacy incidents, client escalations, investigations, CAPs, audit findings, and other compliance matters.
• Track open items, responsible parties, deadlines, corrective actions, and closure.
• Provide regular compliance reporting and significant issue updates to executive leadership.
• Identify trends, repeat incidents, overdue corrective actions, and areas of increased organizational risk.
• Work collaboratively with Operations, Human Resources, IT, Information Security, Legal, and executive leadership.

Educational Requirement:

Bachelor's degree in Healthcare Administration, Compliance, Business, Legal Studies, or a related field.

Experience Requirements:

Required:

• 5+ years of healthcare compliance, HIPAA/privacy, health plan, MSO, IPA, TPA, delegated healthcare, or similar healthcare experience.
• Strong working knowledge of

HIPAA, PHI

privacy requirements, and healthcare compliance practices.

• Experience investigating and documenting PHI, privacy, or other healthcare compliance incidents.
• Experience in preparing professional written responses to clients regarding compliance matters.
• Strong policy, procedure, investigation, and documentation skills.
• Strong written and verbal communication skills.
• Ability to independently manage multiple compliance matters and follow issues through final resolution.
• Ability to work with executive leadership and cross-functional departments while handling sensitive and confidential matters.

Preferred:

• Experience working for or with health plans, IPAs, MSOs, delegated entities, or healthcare service organizations.
• Experience supporting healthcare operations performed by U.S. and offshore teams.
• Experience with client audits, delegation audits, corrective action plans, compliance attestations, and regulatory documentation.
• Experience with privacy/security incident response and coordination with Information Security or a CISO.
• Healthcare compliance certification such as CHC, CHPC, CHPS, or equivalent is preferred but not required.

Work Location Primary office location:

Ontario, California Pay:

$100,000.00 - $120,000.00 per year

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance

Work Location:

Hybrid remote in Ontario, CA 91764