Compliance Investigations Manager

InnovAge•Denver, CO

1d•$90,000 - $120,000

About The Position

A Compliance Investigators Manager ensures an organization follows laws, regulations, and internal policies by conducting investigations into potential breaches like fraud, harassment, or non-compliance, gathering evidence, interviewing witnesses, preparing detailed reports, and recommending corrective actions to mitigate risk and maintain integrity, requiring strong analytical and communication skills. Essential Functions and Work Responsibilities Functional Category: Compliance Investigations Estimated Percent of time Spent – 100% Key Responsibilities: Conduct Investigations: Probe potential violations of laws, regulations (e.g., healthcare, finance), and company policies. Gather & Analyze Evidence: Collect and interpret data, documents, and physical evidence, in collaboration with other Compliance staff. Interview Stakeholders: Speak with witnesses, complainants, and subjects to uncover facts. Document Findings: Prepare comprehensive reports, summaries, and investigation plans, detailing findings and evidence. Risk Assessment: Identify vulnerabilities and areas prone to non-compliance. Recommend Solutions: Suggest corrective actions and improvements to policies and procedures. Liaise: Work with legal, HR, and other departments, and sometimes external agencies. Conflict of Interest: Develop, implement, and oversee the organization's COI program, acting as an expert to train staff, manage disclosures, research potential conflicts, and ensure compliance with laws/policies. Typical Duties: Manage the Investigations & COI software portal Handling complaints and disclosures via the Convercent portal (e.g., discrimination, fraud, contract breaches, COI). Review for new submission, assign owners, open/close investigations, clear disclosures. Maintaining meticulous records of all investigative and COI activities. Providing training or presentations on compliance matters. Schedule monthly meetings with CCO, Director of Compliance, and Director of Safety to provide updates on all outstanding investigations. Schedule Monthly meetings with CCO, VP Associate General Counsel, Senior Director Employee Relations to provide updates and reviews of all outstanding COIs and disclosures. Prepare and distribute monthly Ethics & Integrity Action Line Updates to ELT. Manage COIs by implementing yearly campaigns, distribution of communications, follow up on outstanding COIs, and escalation of non-compliance. InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model. InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.

Requirements

Bachelor's degree in a related field (Business, Finance, Criminal Justice) or a combination of related experience and education.
Minimum of five years' related experience.
Analytical & Investigative Skills: Strong ability to find and interpret evidence.
Communication: Excellent written and verbal skills for reports and interviews.
Integrity & Discretion: Handle sensitive information ethically.
Industry Knowledge: Familiarity with relevant laws (finance, healthcare, etc.).

Nice To Haves

Prior experience with legal compliance investigations
Experience working within healthcare EMR
Healthcare administration

Responsibilities

Conduct Investigations: Probe potential violations of laws, regulations (e.g., healthcare, finance), and company policies.
Gather & Analyze Evidence: Collect and interpret data, documents, and physical evidence, in collaboration with other Compliance staff.
Interview Stakeholders: Speak with witnesses, complainants, and subjects to uncover facts.
Document Findings: Prepare comprehensive reports, summaries, and investigation plans, detailing findings and evidence.
Risk Assessment: Identify vulnerabilities and areas prone to non-compliance.
Recommend Solutions: Suggest corrective actions and improvements to policies and procedures.
Liaise: Work with legal, HR, and other departments, and sometimes external agencies.
Conflict of Interest: Develop, implement, and oversee the organization's COI program, acting as an expert to train staff, manage disclosures, research potential conflicts, and ensure compliance with laws/policies.
Manage the Investigations & COI software portal
Handling complaints and disclosures via the Convercent portal (e.g., discrimination, fraud, contract breaches, COI). Review for new submission, assign owners, open/close investigations, clear disclosures.
Maintaining meticulous records of all investigative and COI activities.
Providing training or presentations on compliance matters.
Schedule monthly meetings with CCO, Director of Compliance, and Director of Safety to provide updates on all outstanding investigations.
Schedule Monthly meetings with CCO, VP Associate General Counsel, Senior Director Employee Relations to provide updates and reviews of all outstanding COIs and disclosures.
Prepare and distribute monthly Ethics & Integrity Action Line Updates to ELT.
Manage COIs by implementing yearly campaigns, distribution of communications, follow up on outstanding COIs, and escalation of non-compliance.