Compliance Program Administrator

St. Jude Children's Research Hospital • Memphis, TN

71d • $86,320 - $154,960

About The Position

We are seeking a highly skilled and detail-oriented Compliance Program Administrator with a strong background in hospital billing compliance to join our Healthcare Compliance team. The ideal candidate will have at least five (5) years of experience in hospital billing compliance, with in-depth knowledge of Medicaid Recovery Audit Contractor (RAC) processes, payer guidelines, and the regulatory frameworks governing healthcare reimbursement. This role plays a critical part in ensuring that our institution maintains full compliance with federal and state regulations, payer requirements, and internal policies related to billing, coding, and documentation.

Requirements

• Bachelor’s degree in a relevant field is required.
• Minimum of five (5) years of directly applicable compliance experience (e.g., governance, auditing and monitoring, training, risk assessment, investigation of compliance concerns, and action recommendations).
• Prior compliance program management experience required.
• Demonstrated record of success and proven performance in previous compliance roles.

Nice To Haves

• Experience with clinical research billing guidelines is preferred.

Responsibilities

• Lead and manage the hospital billing compliance program across inpatient and outpatient services.
• Perform risk-based evaluations of internal and external compliance trends to inform program focus areas.
• Monitor and interpret Medicaid Recovery Audit Contractor (RAC) activity, including appeals and corrective actions.
• Ensure adherence to payer-specific guidelines, including Medicare, Medicaid, and commercial payers.
• Conduct internal audits, monitor activities, and risk assessments to identify billing and coding discrepancies.
• Collaborate with Revenue Cycle, Revenue Integrity, Health Information Management Services (HIMS), and clinical departments to resolve compliance issues.
• Establish and maintain a role as a trusted partner and subject matter expert with key stakeholders and compliance collaborators.
• Develop and deliver training programs on billing compliance, RAC audits, and payer regulations.
• Maintain current knowledge of CPT, HCPCS, ICD-10, and other coding standards.
• Prepare and present compliance reports to senior leadership.
• Support responses to external audits and regulatory inquiries.
• Assist in policy development and updates based on regulatory changes and institutional needs.
• Support other strategic and operational initiatives of the Compliance Office.

Benefits

• A reasonable estimate of the current salary range is $86,320 - $154,960 per year for the role of Compliance Program Administrator.

What This Job Offers

• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees