Compliance Manager

9 hours, 38 minutes ago
Full-time
Senior
Legal
Herself Health

Herself Health

Herself Health provides personalized primary healthcare services specifically tailored for women aged 60 and above, focusing on their unique physical, emotional, mental, and social health needs.

Health Care Providers & Services
11-50
Founded 2022
$33M raised

Description

  • Maintain compliance policies, including annual reviews, version control, approvals and workforce publication.
  • Manage the Code of Conduct and annual workforce, contractor and vendor attestations.
  • Serve as the operational compliance contact and maintain the annual work plan, risk assessment, committee materials and Board reporting.
  • Deliver, document and track compliance and fraud, waste and abuse training; address completion gaps and develop targeted education.
  • Administer the compliance hotline and reporting channels, triage concerns and maintain case logs.
  • Conduct exclusion and sanction screenings at hire and monthly, including OIG, SAM and applicable state lists.
  • Coordinate Medicare Advantage downstream-entity attestations, payer audits and data requests, and review outreach materials for CMS requirements.
  • Execute audit and monitoring activities, report findings and coordinate corrective actions.
  • Conduct and document compliance investigations with legal, clinical leadership and outside counsel as needed.
  • Support collaborative physician agreements and other regulatory requirements with clinical and interdisciplinary partners.

Requirements

  • Bachelor's degree or an equivalent combination of education and directly relevant experience.
  • Hands-on healthcare compliance experience involving Medicare, Medicare managed care, Medicare Advantage or other complex government payor requirements.
  • Working knowledge of federal fraud and abuse laws, including the Anti-Kickback Statute, False Claims Act, Civil Monetary Penalties Law and physician self-referral law.
  • Working knowledge of HIPAA privacy and security requirements.
  • Experience with value-based or risk-bearing Medicare Advantage or state Medicaid arrangements (preferred).
  • Ability to work remotely or in a hybrid arrangement, with periodic in-person collaboration and travel to clinics, payer meetings and audits.
  • Availability for occasional work outside standard hours for time-sensitive investigations, breach assessments or regulatory deadlines.
  • Ability to handle sensitive protected health information and personnel matters.

Benefits

  • Compensation of $90,000–$105,000, depending on experience.
  • Remote or hybrid work arrangement.
  • Periodic in-person collaboration with clinic teams and external partners.

Interested in this position?

Apply directly on the company website

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