Compliance Manager

evolvedMD•Scottsdale, AZ

6d•$85,000 - $115,000•Remote

About The Position

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.

Requirements

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.
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.

Nice To Haves

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.

Responsibilities

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.
Develop and execute compliance auditing and monitoring activities.
Analyze findings, identify trends, and recommend corrective actions.
Track remediation efforts through completion.
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.
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.
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.
Maintain audit logs, investigation records, and compliance tracking systems.
Track compliance metrics, trends, corrective actions, and training completion.
Partner with clinical operations, quality, credentialing, revenue cycle, information security, and human resources teams.
Support external audits, accreditation activities, and regulatory reviews.