Compliance Manager (49541)

BAY AREA COMMUNITY HEALTH•Fremont, CA

43d•$106,392 - $123,344•Onsite

About The Position

The Compliance Manager is responsible for ensuring that policies and procedures comply with the regulatory and ethical standards of the organization, as well as its accreditation standards, by implementing and administering practices, programs, and policies. The Compliance Manager ensures that everyone adheres to legal standards and in-house policies. This role involves performing regular audits, implementing policies, and designing control systems, business procedures, and processes to ensure compliance. A key responsibility is overseeing the claims management process and processing of claims-related activities under the Federal Tort Claims Act (FTCA), serving as the claims point of contact.

Requirements

Four-year college degree or equivalent.
Significant experience in researching and interpreting laws and regulations.
Strong PC skills.
Excellent oral and written communication skills.
Effectively communicate regulatory rules and requirements to supported business units.
Communicate accurate and timely information to key stakeholders, and model professionalism, openness, and respect.
Good problem-solving skills and the ability to work independently.
Handle moderately complex issues and problems and refer more complex issues to higher-level staff.
Demonstrate in-depth knowledge and expertise of applicable lending laws and regulations, including knowledge of key industry resources, to ensure sound guidance is provided.
Develop and build functional expertise in processes.
Self-starter, organized, analytical, detail-oriented.
Attend workshops, training, and meetings as needed, and as requested.

Nice To Haves

Compliance certification from a recognized trade organization (e.g., CUCE, NCCO, CRCM) preferred, but not required.

Responsibilities

Develop and maintain the claims management process for addressing any potential or actual health or health-related claims including medical malpractice claims, which may be eligible for FTCA coverage.
Oversee the claims management process and processing of claims-related activities under FTCA and serve as the claims point of contact.
Analyze internal business systems to ensure compliance with industry regulations and ethical standards.
Create, modify, update, and implement policies.
Develop risk management strategies.
Design control systems to address cases of violation of internal business policies.
Design ongoing training programs for employees of the organization.
Liaise with Sr. Leadership and management team to ensure that all business operations are in line with the organizational policies.
Advise Sr. Leadership on business operations relating to investment, risks, and any other policy development.
Participate in the review and recommendation of department policies and procedures to ensure operations are compliant with applicable laws and regulations.
When requested, assist staff with job aids and forms.
Lead compliance reviews and document and support compliance findings.
Draft compliance reports and communicate findings to management.
Conduct initial reviews of alleged compliance violations and escalate to management as needed.
Monitor and track applicable federal and state laws and regulatory guidelines and regulations applicable to the organization.
Identify impacted business units and coordinate with business teams to implement necessary operational or policy changes in response to regulatory change.
Support product development and process change management by participating in meetings with project teams to ensure compliance with regulations and internal policies and procedures, as applicable.
Independently track and record changes to federal regulation and work with the organization to determine impact to processes and operations.
Independently research laws and regulations impacting the organization.
Regularly respond to staff regarding questions on compliance issues with appropriate, risk-based, and properly supported guidance.
Identify training needs of the organization and recommend training subjects to Compliance and/or Learning & Development.
Review marketing forms, advertisements, disclosures, website, and other materials for compliance.
Aid the Director of Compliance in reviewing and analyzing regulatory proposals issued for comment by various regulatory agencies.
Respond to regulatory examiners (responding to regulatory requests, producing documents and/or leading exams).
Perform other duties that may be required and assigned by the supervisor.