Compliance Program Manager

Intermountain Health•Dayton, OH

1d•$52 - $80•Hybrid

About The Position

The Compliance Program Manager partners with leaders, physicians, clinicians, caregivers, and other stakeholders to navigate complex compliance risks, advance initiatives, and strengthen organizational practices. The role oversees a portfolio of sensitive projects and programs and applies expertise in risk compliance, facilitation, critical thinking, and relationship building to foster a culture of compliance and integrity. This is a hybrid position requiring on-site presence at times for training and meetings. Core business hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.

Requirements

High school diploma or GED.
Professional experience in a regulatory, compliance, or risk management role in the healthcare sector.
Thorough knowledge of federal and state healthcare laws and regulations related to billing, coding, reimbursement, contracting, and risk adjustment, including Medicare, Medicaid, HIPAA, the False Claims Act, Anti-Kickback Statute, Stark Law, and MACRA.
Ability to interpret and apply complex healthcare regulations in a healthcare system, assess and evaluate gaps, and demonstrate knowledge of the healthcare industry.
Strong communication, presentation, and interpersonal skills, with the ability to influence and collaborate with diverse stakeholders.
Discretion in maintaining confidential information, evaluating alternatives, and making effective decisions.
Experience implementing the eight elements of an effective compliance program.
High ethical standards, integrity, and professionalism, with commitment to Intermountain Health's mission, vision, values, and compliance framework.

Nice To Haves

Bachelor's degree in healthcare administration or a related field from an accredited institution.

Responsibilities

Establish and maintain effective relationships and communication channels with internal and external stakeholders, and promote mechanisms that encourage a culture of compliance and reporting.
Lead or participate in cross-functional teams to address regulatory risk and implement regulatory requirements through projects and assignments.
Evaluate and identify risks, and develop and lead corrective action plans across an assigned portfolio of products, service lines, or geographies.
Propose plans to adjust organizational risk responses and lead implementation of changes with oversight and direction.
Develop and implement corrective action plans and remediation measures for compliance issues or deficiencies identified through audits, investigations, or regulatory agencies.
Monitor and analyze changes in the regulatory environment and enforcement landscape, assess their organizational impact, and implement monitoring and auditing activities based on industry best practices.
Provide leaders and business units with guidance and support on regulatory compliance issues and requirements, and recommend solutions to ensure compliance.
Develop and deliver compliance education and training programs for relevant stakeholders, including employees, providers, and business partners.
Investigate and respond to compliance complaints, allegations, or incidents, coordinating with legal counsel, human resources, and other departments as appropriate.
Identify and implement best practices and continuous improvement initiatives to enhance regulatory compliance performance and culture.
Promote a culture of compliance and ethics and reduce Intermountain's risk of government audits, fines, penalties, and sanctions through close coordination with Compliance Department leadership.