Compliance Manager (RN)

Habitat Health provides integrated medical and social care to older adults through the PACE program. The Compliance Manager oversees readiness for and management of CMS and State Administering Agency audits, reports audit findings and metrics, and partners with internal teams to strengthen compliance and audit outcomes.

Responsibilities

Audit readiness activities for CMS and SAA audits, including internal monitoring of audit universe data (ex. medical records), training, review of applicable company policies/procedures, and corresponding processes

Live audit management, including serving point with the CMS and SAA audit teams, submission quality assurance, and corrective action plan development, approval, and monitoring

Expertise on PACE audit data, trends, best practices, and risk mitigation and responses to audit-related questions and business development components

Regular and consistent internal audit-related reporting and metrics for the Chief Medical Officer, the Executive Compliance Committee, and compliance subcommittee of the Board of Managers

Makes recommendations for updates to the Compliance Department's annual auditing and monitoring workplan and recommendations to the business on needed areas of focus based on audit findings and PACE regulatory trends

Build and fosters collaborations with the Habitat Population Health and Practice Operations teams regarding audit-related impacts to the Quality Improvement Program and center operations

Performs other Compliance Department duties, as needed

As a member of the Compliance Department, the Audit Manager is also expected to represent the compliance program within the Habitat Health team, including:

Developing and maintaining productive relationships with all levels of staff; and championing the compliance program

Some travel will be required, including but not limited to, travel in anticipation and support of regulatory audits

Preferred

Experience in PACE compliance highly preferred

Bachelor's degree in health care administration, public health, health care operations, public policy, or a clinical field

Certified in Healthcare Compliance (CHC)

Experience with DHCS and/or CMS

Working knowledge of Epic

Experience developing or delivering training (compliance) to adult learners

PACE Compliance

Healthcare Administration

Public Health

Healthcare Operations

Public Policy

Clinical Expertise

DHCS Experience

CMS Experience

Epic

Compliance Training

Adult Learning

Benefits

Remote position

Target annual bonus of 10%

May be eligible for additional incentive compensation, as applicable

Medical, dental, and vision insurance

Paid parental leave

Short- and long-term disability coverage

Life insurance

Flexible spending accounts

401(k) savings plan that includes a match

Paid time off

Company paid holidays

Company

PACE-based health and social care for Medicare/Medicaid older adults

California, Kentucky, USA

https://www.habitathealth.com/

Founded in 2023

51-200 employees

Qualifications

Minimum of three (3) years of experience in healthcare audit or related field

Active and unrestricted Registered Nurse (RN) License

Aligns with our purpose and our values, and is excited about living those out in daily practice

Ability to lead with influence

An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying

Ability to work in a fast-paced environment and in an efficient manner

Optimistic and can-do approach

Excellent organizational skills and attention to detail

Ability to review and interpret data and make data-based recommendations

Excellent interpersonal, verbal, and written communication skills

Manage multiple projects and identify opportunities for internal and external collaboration

Knowledge of the Microsoft 365 suite

Experience in PACE compliance highly preferred

Bachelor's degree in health care administration, public health, health care operations, public policy, or a clinical field

Certified in Healthcare Compliance (CHC)

Experience with DHCS and/or CMS

Working knowledge of Epic

Experience developing or delivering training (compliance) to adult learners

Minimum of three (3) years of experience in healthcare audit or related field.

Required skills

Healthcare Auditing, Registered Nurse (RN) License, PACE Compliance, CMS and State Administering Agency Audits, Microsoft 365, Certified in Healthcare Compliance (CHC), Epic, DHCS and CMS, Data Analysis, Compliance Training

Preferred skills

Experience in PACE compliance highly preferred, Certified in Healthcare Compliance (CHC), Experience with DHCS and/or CMS, Working knowledge of Epic

Experience

3+ years