Compliance Manager

 Posted 8 hours ago
     
 $85000 - $115K per year
  
2-5 years experience
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AI Summary

The Compliance Manager oversees the company's compliance program across behavioral health and psychiatric service lines. Key duties include conducting audits, managing internal investigations, and ensuring adherence to federal and state regulatory requirements.

Compliance Manager

The Compliance Manager is responsible for supporting and maintaining the company's compliance program across three services lines: integrated behavioral health / Collaborative Care Model (CoCM), outpatient therapy, and outpatient psychiatric services.

This role oversees day-to-day compliance activities, including auditing, monitoring, investigations, policy management, regulatory research, corrective action planning, and staff education.

The Compliance Manager works collaboratively with clinical, operational, quality, credentialing, revenue cycle, and leadership teams to promote a culture of compliance, ethical conduct, patient safety, and regulatory adherence.

Location: This position can be remote in AZ, UT, CO, or NM 

Compensation

  • First-year compensation $85,000 - $115,000 annually (DOE) 
  • $1,200 annual technology allowance
  • 401(k) company match up to 3%

Essential Duties and Responsibilities

Compliance Program Operations

  • Support implementation and ongoing administration of the company's compliance program.
  • Assist with annual compliance work plans, risk assessments, and monitoring activities.
  • Maintain compliance policies, procedures, and related documentation.
  • Monitor federal and state regulatory requirements impacting behavioral health, psychiatry, telehealth, and Collaborative Care services.
  • Assist leadership in evaluating regulatory changes and operational impacts.

Auditing and Monitoring

  • Develop and execute compliance auditing and monitoring activities.
  • Analyze findings, identify trends, and recommend corrective actions.
  • Track remediation efforts through completion.

Investigations and Incident Management

  • Manage compliance concerns, hotline reports, and internal investigations.
  • Conduct fact-finding activities and document investigation outcomes.
  • Coordinate corrective action plans when deficiencies are identified.
  • Support review of patient complaints, adverse events, privacy incidents, and regulatory concerns.

Regulatory Compliance + Accreditation

  • Monitor regulatory changes across the healthcare landscape and translate requirements into operational policies and procedures.
  • Maintain regulatory tracking tools and compliance resources.
  • Lead accreditation readiness and compliance efforts by monitoring adherence to applicable healthcare accreditation standards, coordinating evidence collection, facilitating survey preparation, and supporting continuous regulatory and quality improvement initiatives.

Education and Training

  • Develop and deliver compliance education and awareness programs.
  • Support new employee compliance orientation.
  • Assist leaders in implementing targeted training based on audit findings and identified risks.
  • Promote a culture of ethical conduct and accountability.

Reporting and Analytics

  • Maintain audit logs, investigation records, and compliance tracking systems.
  • Track compliance metrics, trends, corrective actions, and training completion.

Cross-Functional Collaboration

  • Partner with clinical operations, quality, credentialing, revenue cycle, information security, and human resources teams.
  • Support external audits, accreditation activities, and regulatory reviews.

Qualifications

Required Education and Experience

  • Bachelor's degree in healthcare administration, public health, business administration, compliance, or related field.
  • Minimum of 3 years of healthcare compliance, audit, quality, risk management, behavioral health, or related experience.
  • Experience interpreting healthcare regulations and conducting compliance investigations.
  • Experience developing corrective action plans and monitoring remediation activities.

Preferred Qualifications

  • Experience in outpatient behavioral health, psychiatry, or Collaborative Care Model (CoCM) programs.
  • Experience with Medicare and Medicaid billing compliance.
  • Experience supporting accreditation readiness (CARF, Joint Commission, etc.)
  • Experience with electronic health record systems and healthcare analytics.

 Knowledge, Skills, and Abilities

  • Strong understanding of healthcare compliance program requirements and regulatory frameworks.
  • Knowledge of HIPAA, fraud, waste and abuse prevention, Medicare regulations, and behavioral health compliance requirements.
  • Strong auditing, investigative, analytical, and problem-solving skills.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple priorities and deadlines independently.
  • Proficiency with Microsoft Office applications and data analysis tools.
  • Ability to maintain confidentiality and exercise sound professional judgment.

About Us

At evolvedMD, we are leading the integration of behavioral health services in modern primary care. How? We use a uniquely upfront, innovative, and ongoing approach that places our clinicians on site and in person at each of the practices we serve. As one of America’s largest and most seasoned companies dedicated to integration, we fully embed behavioral health managers into a collaborative team. evolvedMD is committed to meeting patients where they are most comfortable: whether that is in person and on site at your practice location or virtual. We offer early, comprehensive, and dedicated care to help patients achieve the best possible behavioral health outcomes.

To find out more about what it’s like to work at evolvedMD, visit our Resources and News page at https://www.evolvedmd.com/resources where you can learn about our culture, leaders, innovations, and impact in the community.

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