Compliance Audit Manager

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

A bit more about this role: 

The Compliance Audit Manager will be an integral part of a dedicated team that collaborates across various departments to ensure adherence to federal, state, and local regulations, ultimately enhancing patient care and operational integrity. This position is pivotal in overseeing audit and monitoring activities related to our multi-state Medical Group Practice, requiring a candidate with strong audit experience, research skills regarding regulatory requirements, exceptional organizational abilities, and a proactive mindset to drive continuous program improvements. Key attributes for success include adaptability in a dynamic environment, and excellent collaboration skills to work effectively with business leaders while managing multiple priorities in a fast-paced setting and ensuring we achieve our compliance work plan objectives. With these responsibilities and attributes, you will play an integral role in nurturing a culture of compliance and contributing to the overall success and integrity of our organization. Your proactive approach and collaborative spirit will directly enhance our compliance efforts and secure our organizational goals.
 

Responsibilities will include:

• Strong knowledge of healthcare regulatory and compliance requirements, standards, analytics and reporting.

• Staying updated on federal and state healthcare laws like HIPAA, Medicare, Medicaid, and state licensing requirements to ensure the practice is operating compliantly.

• Advanced knowledge of Medicare and Medicaid program rules and regulations and experience applying to coding and billing of professional services.

• In-depth ability to collaborate effectively with senior staff and management across departments, providing advice and guidance on complex revenue cycle and regulatory compliance issues of functionality, efficiency, and program development.

• Conduct annual and targeted risk assessments which support the development of the compliance work plan. 

• Oversee audit and monitoring processes from planning to completion, ensuring timely identification and resolution of compliance deficiencies.

• Collaborate with operational leaders to develop corrective action plans and track progress to ensure timely implementation of remediation plans and conduct post implementation validation testing.

• Assists with maintaining regular and consistent compliance performance reporting and metrics for the Compliance department, including but not limited to dashboards, board reporting, weekly, monthly, and annual compliance reporting.

Required skills and experience:

• Bachelor's Degree in Business, Public Health, or related field; equivalent combination of education and experience accepted.

• Over five years of experience in Healthcare Compliance, including expertise in audit and monitoring processes and regulatory analysis. 

• Certified Coder or equivalent experience and experience in revenue cycle compliance

• Proven ability to develop and implement comprehensive risk assessments and audit plans.

• Familiarity with state regulatory requirements and medical practice  compliance standards.

• Demonstrated proficiency in applying compliance and ethics standards within both medical practice management and managed care environments.

• Ability to Simplify Complexity - Break down complex compliance challenges into actionable steps, facilitating easier implementation.

• Adaptability to a Fast-Paced Environment - Thrive in a dynamic work setting, balancing multiple responsibilities while maintaining effectiveness.

Desired skills and experience:

• Certification in Healthcare Compliance (CHC) preferred, showcasing commitment to professional standards in the field.

• Working with a multistate telehealth based provider group

• Experience working with the Google tools, Jira, Confluence, and Slack 

• Basic knowledge and use of Large Language Models 

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Salary Range: $76,000-$120,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.