Compliance Manager, Physician Practices and Ambulatory Care

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Compliance Manager for Physician Practices and Ambulatory Care is responsible for the development, implementation, and oversight of the compliance program for the organization's physician practices and affiliated ambulatory care services. This position ensures the integrity of the practice's regulatory environment by actively monitoring changes in healthcare laws and regulations. The manager will proactively research, investigate, and respond to issues related to documentation, coding, billing, and licensure. This role is critical in assuring compliance with all payer and regulatory requirements, including but not limited to those of Medicare, Medicaid, and applicable state laws. This is a Hybrid Position overseeing 4 people

Qualifications:

Education, Knowledge, Skills and Abilities Required:

Bachelor's degree in Healthcare Administration, Business Administration, or a related field. Minimum of 5-7 years of experience in healthcare compliance, with significant experience in auditing, coding, and physician practice/ambulatory care settings. In-depth knowledge of federal and state healthcare regulations, including Stark Law, Anti-Kickback Statute, and HIPAA. Proficiency with ICD-10 and CPT-4 coding methodologies, physician documentation, and reimbursement principles. Demonstrated experience in developing and implementing compliance programs, conducting audits, and leading investigations. Proficiency in the use of electronic health records (EHRs), preferably Epic Ambulatory. Strong analytical, problem-solving, and project management skills. Excellent interpersonal, presentation, and written communication skills. High degree of professionalism, integrity, and ability to work collaboratively with physicians, staff, and leadership. Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Education, Knowledge, Skills and Abilities Preferred:

Familiarity with The Joint Commission (TJC), state Department of Health, and CMS regulations. Proficiency in Epic Ambulatory.

Licenses and Certifications Preferred:

Certification in Healthcare Compliance (CHC). A coding credential (e.g., CPC, CCS). If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!