Compliance Manager

The Compliance Manager is a highly accountable, on-site departmental manager responsible for the day-to-day supervision, operational productivity, and performance metrics of the frontline compliance and clerical staff. 

This role owns the daily execution of policies across Health Information Management (HIM), Billing Compliance, and Records Production. Working in tandem with and supported by the General Counsel and Chief Regulatory Officer, the Compliance Manager is directly tasked with mitigating operational vulnerabilities, professionalizing frontline workflows, and enforcing systematic data-auditing protocols to close identified compliance gaps.

The Compliance Department exists:

• As a channel of communication to receive and direct compliance issues to appropriate resources for investigation and resolution,
• As a coordinator of various departments to meet the current and future regulatory and corporate compliance requirements,
• As a tool to conduct continuous monitoring of compliance through periodic internal audits and self-assessments,
• As a conduit to train and educate employees to establish and maintain an organizational culture that encourages ethical conduct and a commitment to compliance with the law, and
• As a final internal resource with which concerned parties may communicate after other formal channels and resources have been exhausted.

DUTIES AND RESPONSIBILITIES: This job description is not intended, nor should it be construed, to be an all-inclusive list of responsibilities, duties, skills, or working conditions associated with the job.  It is intended to be a general description of the essential duties and requirements common to positions of this type and may be subject to change.  Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. 

• Manages day-to-day operation of the Compliance Department.
• Daily Floor Supervision: Assume active, on-floor ownership and operational management of the 15-person clerical and technical staff across HIM, Billing Compliance, and Records Production.
• Supervisor Mentorship & Development: Provide daily direction, professional coaching, and accountability metrics to the department's frontline team supervisors to bridge technical performance and leadership gaps.
• Administrative Accountability: Direct all baseline personnel workflows, including timesheet approvals, performance evaluations, routine 1:1 operational syncs, coverage scheduling, and disciplinary actions.
• SOP Standardization: Standardize departmental workflows and maximize clerk utility by fully integrating and maintaining a reference standard for all frontline staff.
• Incident Escalation & Tracking: Own the initial intake, investigation, and logging of localized compliance and data breach incidents; partner with the Senior Regulatory Counsel for final regulatory assessment and executive reporting.
• Culture & Efficiency Management: Act as the operational firewall on the floor to eliminate employee idle time, resolve inter-team operational friction, and streamline data output across corporate divisions.
• Policy Development and Review: Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct.
• Collaboration: Collaborates with other departments (e.g., Legal, Information Technology, Human Resources, Acadian Client Services, Divisional Operations, HSE, Training, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with in house counsel as needed to resolve difficult legal compliance issues.
• Resolution: Develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
• Reporting: Provides reports on a regular basis, and as directed or requested, to keep the Board, the Senior Vice President of Legal and Governmental Affairs, the Compliance Committee and senior management informed of the operation and progress of compliance efforts.
• Compliance Hotline: Establishes and provides direction and management of the compliance Hotline.
• Communication: Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline; (b) heightened awareness of current policies and procedures, and (c) understanding of new and existing compliance issues and related policies and procedures.
• Performance: Monitors the performance of the Compliance Program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness.

QUALIFICATIONS:

• Education: Bachelor’s degree in Business Administration, Healthcare Administration, Management, or a related field preferred (or equivalent combined practical supervisory experience). Advanced legal or specialized compliance degrees are not required.
• Experience: A minimum of 3 years of direct personnel management, team leadership, or supervisory experience. A working knowledge of the Health Insurance Portability and Accountability Act. Background in managing high-volume clerical workflows, medical billing operations, call centers, or customer service environments is highly valued.
• Core Competencies: Strong operational leadership and conflict-resolution capabilities; proven ability to enforce schedules and optimize team productivity; proficiency in deploying standardized SOP software and playbooks; exceptional tracking, organizing, and floor-management skills.