Compliance Manager

Mental Health Cooperative•Nashville, TN

10d•Onsite

About The Position

The Compliance Manager is responsible for the development, implementation, and ongoing oversight of the organization’s Compliance Program to ensure adherence to applicable federal and state laws, regulations, accreditation standards, payer requirements, and internal policies. This role supports organizational integrity, risk mitigation, and ethical operations by fostering a culture of compliance, accountability, and continuous improvement across all levels of the organization. The Compliance Manager ensures the effective and efficient use of behavioral healthcare resources in the delivery of high quality, compliant consumer care. This position assists in preventing, detecting, and responding to potential regulatory and compliance risks by partnering with leadership to strengthen clinical, financial, and administrative operations. The role provides guidance on federal and state regulatory and payment requirements, private contracting considerations, and issues related to the prevention and detection of fraud, waste, and abuse. Additionally, the Compliance Manager supports the coordination, communication, implementation, and monitoring of all compliance activities and programs in alignment with the organization’s Corporate Compliance Program.

Requirements

Bachelor’s degree in healthcare administration, compliance, business, law, nursing, behavioral health, or related field.
Minimum 5 years of progressive experience in compliance, healthcare administration, risk management, or regulatory oversight.
Demonstrated knowledge of healthcare compliance regulations and standards.
Strong analytical, investigative, and problem-solving skills.
Excellent written and verbal communication abilities.
Ability to work independently, manage competing priorities, and handle sensitive information with discretion.
Strong understanding of compliance program elements and OIG guidance.
Ability to interpret regulations and translate requirements into operational practice.
High level of professional judgment, integrity, and discretion.
Collaborative leadership style with the ability to influence across departments.
Proficiency with compliance tracking, audit, and reporting tools.

Nice To Haves

Master’s degree (MPH, MHA, MBA, JD, or related field).
Certification such as: Certified in Healthcare Compliance (CHC) Certified Compliance & Ethics Professional (CCEP) Certified Professional in Health Care Risk Management (CPHRM) Six Sigma Master Black Belt (SSMBB)
Experience in behavioral health, nonprofit healthcare, or multisite healthcare organizations.
Experience supporting governance level compliance activities.

Responsibilities

Manage the day-to-day operations of the Corporate Compliance Program in accordance with OIG guidance and organizational standards.
Support the development, implementation, maintenance, periodic review, and revision of compliance policies, procedures, and standards.
Maintain a working knowledge of applicable federal and state laws, regulations, accreditation standards (e.g., The Joint Commission, TDMHSAS), payer requirements, and contractual obligations impacting healthcare operations.
Monitor regulatory and enforcement developments and assess organizational impact.
Participate in the annual review and periodic revision of the Corporate Compliance Program.
Design, conduct, and maintain Compliance Risk Assessments to identify, assess, and mitigate regulatory, operational, and safety risks.
Develop and execute the annual compliance work plan.
Conduct audits and monitoring activities related to clinical, operational, financial, and regulatory compliance.
Track corrective action plans, ensure timely resolution of findings, and validate sustained compliance.
Assist leadership in identifying areas of compliance vulnerability and implementing corrective actions that consider patient safety infrastructure.
Receive, assess, and investigate compliance concerns, allegations, or potential violations.
Coordinate investigations with Legal, Human Resources, Risk Management, and leadership, as appropriate.
Document investigative findings, comply with reporting and notification requirements, and ensure corrective actions are implemented and monitored.
Support and reinforce protections against retaliation in compliance reporting.
Develop, implement, and deliver compliance education and training for leadership, staff, and Board members.
Promote awareness of the Code of Conduct, compliance policies, and reporting mechanisms, including the compliance hotline.
Educate leadership on regulatory requirements impacting operations and implement solutions to address compliance barriers.
Actively promote a culture of safety, ethical conduct, accountability, and continuous quality improvement.
Prepare and present regular compliance reports to executive leadership, compliance committees, and the Board.
Support governance bodies with compliance related analysis, documentation, and policy recommendations.
Participate in organizational committees focused on compliance, safety, quality, and risk management.
Contribute clear, actionable compliance insights to executive level discussions.
Maintain compliance documentation, logs, tracking systems, and reporting tools.
Ensure agencywide policies and procedures are reviewed and updated on a defined schedule.
Support enterprise documentation standards and records retention practices.
Participate in the annual review of organizational policies and procedures.
Serve as liaison to state licensure agencies, accreditation bodies, and payer sources.
Coordinate regulatory surveys, audits, licensure renewals, and documentation submissions to ensure timely and accurate completion.
Provide guidance related to federal and state payment requirements, private contracting issues, and prevention of fraud, waste, and abuse.
Partner with operational leaders to integrate compliance into workflows and decisionmaking processes.
Collaborate closely with Risk Management, Quality, and Operations to support coordinated, systemlevel risk mitigation.
Engage early in planning and process design to address regulatory and risk considerations proactively rather than retrospectively.
Translate regulatory requirements into practical, sustainable operational workflows.
Analyze data across investigations, audits, incidents, and monitoring activities to identify trends and recommend improvements.
Perform other duties as assigned in support of the Compliance Program and organizational objectives.