Senior Compliance Manager

Medical Guardian • Philadelphia, PA

8d

About The Position

MedScope, a Medical Guardian company, is seeking a Senior Compliance Manager to safeguard the integrity and long-term success of its operations. The role ensures adherence to state and federal healthcare requirements, particularly Medicaid, Medicare, HIPAA, and healthcare compliance enforcement. The manager will design, implement, and oversee a comprehensive compliance program that mitigates risk and promotes accountability, ethical behavior, and regulatory excellence. The position calls for healthcare compliance expertise, familiarity with personal emergency response systems (PERS), and a proactive approach to problem-solving.

The manager will develop and maintain compliance policies, procedures, training, monitoring, documentation, and enforcement mechanisms; oversee compliance across multiple states; and assess regulatory changes and their operational impact. The role also leads internal audits, risk assessments, corrective action plans, HIPAA oversight, employee education, cross-functional compliance projects, and reporting to executive leadership. The manager partners with legal, operations, and IT teams and supports compliant product launches, technology implementations, contracts, background screening, and fingerprinting processes.

Requirements

• Bachelor’s degree in healthcare administration, business, law, or a related field.
• At least 7 years of experience in healthcare compliance, with a focus on Medicaid, Medicare, and HIPAA regulations.
• Demonstrated experience in auditing, monitoring, and risk management within a healthcare environment.
• Demonstrated experience managing compliance requirements across multiple states, including interpreting state-specific regulations and translating them into operational policies and procedures.
• Strong understanding of state and federal Medicaid and Medicare programs, HIPAA regulations, and healthcare compliance enforcement.
• Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint, and compliance software tools.
• Exceptional project management skills and ability to manage multiple initiatives simultaneously.
• Excellent verbal and written communication skills, including the ability to educate and influence stakeholders at all organizational levels.
• Strong analytical skills, including the ability to assess complex regulations and identify actionable solutions.
• Working knowledge of employee background-screening requirements, including criminal background checks, fingerprinting, consent and disclosure requirements, and appropriate handling of screening results.
• High ethical standards, confidentiality, and commitment to compliance integrity.
• Proactive problem-solving mindset and ability to work independently under tight deadlines.
• Ability to thrive in a dynamic, fast-paced environment with a focus on delivering results.

Nice To Haves

• Master’s degree.
• Relevant certifications such as CHC or CCEP.
• Experience with personal emergency response systems (PERS) and healthcare IT compliance.

Responsibilities

• Design, implement, and maintain a comprehensive compliance program that meets state and federal requirements, including Medicaid, Medicare, and HIPAA regulations.
• Develop and update policies and procedures to reflect regulatory changes, and integrate training, documentation, monitoring, and enforcement into the compliance framework.
• Oversee compliance activities across multiple states; identify regulatory differences and monitor state-specific laws, regulations, and agency guidance; assess operational impacts and coordinate timely implementation.
• Develop and execute internal audit plans to assess compliance with applicable regulations.
• Identify compliance risks, conduct assessments, recommend corrective actions, and oversee Corrective Action Plans through timely resolution.
• Ensure company-wide adherence to HIPAA privacy and security standards relating to Protected Health Information (PHI); monitor for potential violations, initiate investigations, and enforce corrective actions.
• Collaborate with IT and operations teams on compliance involving PERS-related healthcare systems and technology.
• Provide ongoing employee training on compliance policies, ethical standards, and regulatory updates, and educate internal stakeholders, including executive leadership, on Medicaid, Medicare, and HIPAA requirements.
• Lead compliance-driven projects and integrate regulatory requirements into product launches, IT implementations, organizational processes, new initiatives, and contracts.
• Partner with legal, operations, and IT teams and communicate compliance requirements and objectives across departments.
• Develop and maintain policies, procedures, controls, and documentation for employee background screening and fingerprinting processes.
• Maintain compliance documentation, including policies, audit results, risk assessments, and corrective action plans.
• Prepare regular compliance reports for executive leadership detailing activities, findings, and progress.
• Perform other duties as assigned.

Benefits

• Health care plan, including medical, dental, and vision.
• Paid time off, including vacation, sick time off, and holidays.
• Company-paid short-term disability and life insurance.
• Retirement plan (401(k)) with company match.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior