Title: Compliance Manager

Location: Fountain Valley, Hybrid

Department: Compliance

Status: Full Time

Shift: Day

Pay Range*: $105,872.00 - $153,504.00/annually

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

This position, at the direction of the Director of Compliance, assists in the coordination, research, investigation, monitoring, auditing, education and resolution of compliance issues identified by the MemorialCare organization under its formal Board Approved Compliance & Business Ethics Program. This position works with internal staff and departments to manage the external government appeals to ensure timely release of information and appeals.This position will interact frequently with department directors, managers & key individuals throughout the Memorial Health System involved in compliance & ethics related matters.The duties of this position require sound independent decision-making capabilities, excellent written & verbal communication skills, ability to influence, and familiarity with healthcare clinical and business operations.

This position at the direction of the Director of Compliance, assists and directs the activity of the Compliance and Appeals Coordinator and the Compliance Coordinator.

Essential Functions and Responsibilities of the Job

• Conduct effective investigations of privacy and hotline incidences to ensure appropriate and thorough reviews are performed, and timely reporting of confirmed breaches or violations occur
• Self-sufficiently manage the government appeals process to ensure timely follow-up of government requests and submission of appeals are processed
• Contribute to the preparation for and presentation during Compliance Review Committee
• Complete compliance related audits accurately; manage audit timeline to ensure timeliness
• Create detailed Standard Work documents and flows to support compliance department activities
• Use sound independent decision-making to complete ad-hoc assignments
• Stay current with changing legal statutes & regulatory requirements; attend training and educational seminars as necessary
• Other duties as assigned

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Minimum Requirements

Qualifications/Work Experience:

• Minimum 3 years of relevant experience in a health care compliance department preferred.
• Advanced computer skills in Microsoft office products: Work, Excel, PowerPoint, and Outlook.
• Excellent critical thinking skills, and strong verbal and writing skills.
• Exceptional time management skills with ability to meeting deadlines.
• Experience conducting investigations for both privacy and general compliance related concerns, and experience with Medicare auditing programs including RAC, CERT, MACs, TPE, and ZPICs.

Education/Licensure/Certification:

• Bachelors’ degree in a healthcare related field is preferred
• CHC Certification preferred