Compliance Manager

Meta House•Milwaukee, WI

35d•Onsite

About The Position

The Compliance Manager is responsible for developing, implementing, and overseeing the organization’s compliance program to ensure adherence to federal and state regulations, healthcare and privacy laws, and internal policies/standards. This role partners with leadership across clinical, operational, and administrative functions to promote a culture of ethics, integrity, and accountability.

Requirements

Bachelor’s degree - Healthcare Administration, Public Health, Business, Law, or related field required
5–8+ years of experience in healthcare compliance, regulatory affairs, audit oversight/management, or related field required
Strong knowledge of healthcare and privacy regulations (HIPAA, 42 CFR Part 2, Medicare/Medicaid, billing compliance)
Analytical, auditing, and risk assessment skills
Ability to manage sensitive/confidential issues with discretion
Excellent communication and stakeholder engagement skills
Project management and organizational skills

Nice To Haves

Master’s degree (MPH, MHA, MBA, JD) preferred
Experience in a nonprofit healthcare delivery setting strongly preferred
Certificate(s) in healthcare compliance, privacy, internal investigations, ethics or similar disciplines preferred

Responsibilities

Ensure organizational compliance with federal and state regulations (including, but not limited to HIPAA, CMS, OIG guidance, and 42 CFR Part 2 regulations) and contractual requirements
Implement corrective action to ensure regulatory and contractual compliance including policy, procedure and/or training updates
Maintain, update, and draft necessary organizational policies, procedures, and standards of conduct to ensure compliance with regulations and contractual requirements and to meet operational needs
Manage external regulatory audits including state licensing, contractual reviews, and Department of Corrections PREA audits; coordinate and lead required responses including documentation, appeals, and corrective action plans
Lead internal audit efforts and monitoring activities across departments to mitigate risk in areas including confidentiality and disclosure practices, clinical documentation and billing accuracy, client rights and PREA compliance and incident reporting
Analyze trends in external and internal audit findings to proactively identify compliance risks and improvement opportunities
Stay current on regulatory requirements and industry best practices to anticipate and mitigate risk exposure
Advise leadership on compliance obligations and emerging risks, and collaborate with operational and clinical teams to investigate issues and ensure timely resolution
Develop, implement, and track corrective actions and continuous improvement initiatives
Design comprehensive and compliant training program for staff and leadership
Create awareness of compliance standards across the organization and promote a culture of transparency, accountability, and client-centered care
Lead internal incident reporting and investigation efforts and ensure appropriate follow-up including documentation of findings
Coordinate with other departmental leaders including Human Resources and clinical leadership, as needed, to appropriately respond to investigation outcomes
Track and report on compliance metrics and key risk indicators