Manager, Healthcare Compliance and Regulatory Affairs

Job description

What You’ll Do – Job responsibilities The Manager, Compliance and Regulatory Affairs reports to the AVP, Legal & Compliance and has a key role in supporting the implementation of the seven elements of an effective compliance and helping promote the Company's vision, mission, and culture. The Manager, Compliance and Regulatory Affairs supports the AVP, Legal & Compliance in the implementation and strategic direction of Suvida’s Compliance Program (“Program”). This includes creating a compliance strategy that ensures business accountability for oversight over the day-to-day monitoring of the business areas as well as supporting business partners in implementing that strategy. Essential responsibilities consist of but not all inclusive: Manage organization’s healthcare compliance program and support ongoing compliance strategic planning Perform internal audits and monitor operational practices to identify compliance risks Monitor compliance with applicable regulations, including HIPAA, Medicare, Medicaid, CMS, OIG guidance, Stark Law, Anti-Kickback Statue and other healthcare regulations Collaborate with department leaders to implement corrective actions and monitor their effectiveness including: Identifying key watch areas Providing short/long term solutions Supporting accountability and enforcement Monitoring outcomes and progress Regulations and Regulatory Matters Risk management, including privacy and security, patient complaints and other Investigate reported compliance concerns, violations, and potential fraud, waste, or abuse. Supervise and manage Regulatory Compliance team roles as assigned. Develop and deliver compliance education and training programs for employees, providers and leadership. Conduct risk assessments, maintain documentation related to compliance activities, investigation and regulatory inquiries. Coordinate system projects by partnering with accountable business owners and proactively lead efforts to mitigate risks associated with business activities, confirm risk measurement/s and business monitoring and align with internal and regulatory requirements. Create, modify, update and implement company compliance policies and chair the company's Policy Committee. Proactively develop risk management strategies for known, unknown and/or anticipated company risks in partnership with direct supervisor and Compliance team. Lead risk audits; identify risk and/or noncompliance areas and produce actionable, data-driven reports. Monitor regulatory changes and communicate new requirements throughout the organization. Coordinate Root Cause Analyses when indicated and proactively share data, risk management trends and educate stakeholders. Promote ethical decision-making and maintain confidential reporting mechanisms. Provide simple contract review support, analysis and oversight. Perform other duties as assigned What You’ll bring - Education Requirements Bachelor's Degree required Master’s degree in Healthcare Administration, Business Administration, Public Health or a related field in healthcare legal preferred. Certification in Healthcare Compliance (CHC) preferred. What You’ll Bring - Experience Requirements 5+ years’ experience with healthcare compliance, healthcare administration, auditing or healthcare regulatory affairs. Strong knowledge of healthcare laws and regulations, including: HIPAA Privacy and Security Rules Medicare and Medicaid regulations Medicare Advantage regulation s CMS Conditions of Participation OIG Compliance Program Guidance Stark Law Anti-Kickback Statute False Claims Act Experience working in healthcare quality, compliance, operations and supporting the risk assessment process, monitoring or audit activities and response to inquiries. Experience conducting compliance audits and investigations (including breach responsiveness). Bilingual (English and Spanish) preferred. Self-starter and interested in learning and developing expertise in new and emerging areas through education, networking and new experiences. Critical thinking and problem-solving skills. Effective communication and presentation skills; written and verbal. Strong analytical, organizational, and problem-solving skills. Ability to embrace and simplify complex concepts. Strong attention to detail. Excellent written and verbal communication skills. Enjoy building and developing relationships. Located in Texas or Arizona. Who We Are At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered primary care team, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well-being of the seniors we serve. How We Work Our Culture & Core Beliefs Earn Trust Building Relationships Creating Joy Doing Right Improving Every Day Moving Forward Our Promise Purpose Driven Career Competitive Pay Best-In-Class Medical/Dental Coverage Free Mental Health & Life Coaching for Team Members and their Dependents Holiday Time Off with Pay Paid Community Service Day Paid Parental/Family Leave Paid Bereavement Leave Generous Paid Time Off (PTO) 401k Retirement Plan with Company Match And much more....