Healthcare Investigations Manager

Job description

ABOUT OPENLOOP OpenLoop was co-founded by CEO, Dr. Jon Lensing, and COO, Christian Williams, with the vision to bring care anywhere. Our telehealth support solutions are thoughtfully designed to streamline and simplify go-to-market care delivery for companies offering meaningful virtual support to patients across an expansive array of specialties, in all 50 states. About the Role OpenLoop's compliance hotline went live two weeks ago and is already generating reports. As Healthcare Investigations Manager, you'll own intake, triage, and investigation of hotline reports from day one — building the structure this function needs as OpenLoop scales. You'll report to the Sr. Director, Clinical Compliance, with 2 direct reports already in seat. What You'll Do - Intake & Triage: Own intake, triage & investigation of hotline reports; assign cases to team members based on expertise and capacity, with clear guidance on investigation procedures and standards. - Investigation Execution: Conduct thorough investigations of reported concerns — gathering facts, interpreting policy, analyzing data, and handling sensitive matters with discretion; recognize when escalation is necessary. - Response & Remediation: Own the response and corrective-action workflow — define findings, drive remediation, confirm closure, and document investigative steps through resolution. Own Policy Gap analysis. - HIPAA & Security Investigations: Investigate potential HIPAA and Security Policy violations, coordinating with IT Security on related reporting and remediation. - Exclusion Screening: Conduct monthly and new-vendor exclusion screenings against federal and state exclusion lists to mitigate organizational risk. - Self-Disclosure Coordination: Coordinate self-disclosures & escalations with Legal and compliance leadership. - Board & Committee Reporting: Prepare quarterly investigation and disclosure-program reports for senior leadership and the Compliance Committee/Board, identifying trends and supporting risk-assessment discussions. - Systems Administration: Serve as system administrator for the compliance case-management and exclusion-screening platform(s), managing configuration, user access, and data integrity. - Regulatory Alignment: OIG E7 · Response | OIG E4 · Reporting - Team Leadership: Manage and develop 2-3 direct reports; build capacity as hotline volume scales. - Other duties as assigned. Who You Are - Experience running a healthcare investigations or hotline function full-time, ideally in a compliance or regulatory setting. - Direct experience investigating HIPAA/Security Policy violations, ideally in coordination with an IT Security team. - Hands-on experience administering a compliance case-management or hotline platform - Comfortable preparing and presenting investigation trends and disclosure-program data to senior leadership. - Strong root-cause analysis and audit-ready documentation discipline. - Strong Policy gap analysis and working with leaders to implement changes. - Familiarity with OIG guidance, particularly Elements 4 and 7. - Comfortable managing a small team while staying hands-on with casework, especially in an early build phase. - CHC (Certified in Healthcare Compliance) preferred. - High integrity, low-ego collaborator across Legal, Compliance, IT Security, and Operations. OUR BENEFITS In addition, for salaried positions you would also be eligible for: - Medical, Dental, and Vision plans - Flexible Spending/Health Savings Accounts - Flexible PTO - 401(k) + Company Match - Life Insurance, Pet insurance, and more OUR COMPANY We have a relatively flat organizational structure here at OpenLoop. Everyone is encouraged to bring ideas to the table and make things happen. This fits in well with our core values of Autonomy, Competence and Belonging, as we want everyone to feel empowered and supported to do their best work. Sound like a good fit? We’d love to meet you.