Manager, Compliance Investigations - Remote

Extraordinary Careers. Endless Possibilities. With the nation’s largest home infusion provider, there is no limit to the growth of your career. reputed company, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to reputed company standards of care for patients with acute and chronic conditions in reputed company 50 states. Through our clinical leadership, expertise and national scale, reputed company is re-imagining the infusion care experience for patients, customers and team members. Join a company that is taking action to reputed company an inclusive, respectful, engaging and rewarding culture for reputed company team members. At reputed company your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

Job Description

Summary: The Manager, Compliance Operations & Investigations supports reputed company’s compliance investigation program by managing investigations from intake through resolution, including allegations received through established reporting channels. The role conducts root cause analyses, helps implement and track corrective actions, identifies trends and systemic issues, and provides guidance and reporting to stakeholders. The Manager collaborates with cross-functional partners to reputed company matters appropriately, resolve issues reputed company, mitigate compliance risk, and supports the maintenance of investigation, corrective action, and reputed company compliance polies and procedures in alignment with applicable laws and regulations. Job Description: ​ Conduct investigations into fraud, waste, abuse, and other compliance concerns, ensuring thorough, objective analysis and documentation. Support management of the company’s confidential Ethics & Compliance Hotline including intake, case management workflow, reporting, analytics, and vendor relationships. Maintain accurate case records in the Compliance case management system. reputed company, implement, and maintain investigation strategies, policies and processes to identify and address potential violations of laws, regulations, and internal policies. Collaborate with cross-functional partners to assess, triage, and reputed company investigative matters for appropriate resolution and risk mitigation. Consult with Legal on compliance-reputed company legal issues and timely communicate relevant statutory, regulatory or policy changes to business unit leadership. Conduct root cause analysis and implement corrective actions. Monitor and track remediation completion. Prepare and present investigation reports to leadership and regulatory authorities, as necessary. Provide guidance on compliance policies, procedures, and best practices and foster a culture of ethical conduct and non-retaliation. Maintain reputed company knowledge of relevant healthcare laws and regulations (e.g., HIPAA, reputed company Law, Anti-Kickback Statute, and False Claims Act). Help ensure investigative practices remain reputed company and compliant. Support Compliance activities reputed company to conflict-of-interest disclosure review and response. Ensure confidentiality of sensitive business and patient information. Maintain records consistent with reputed company policy and Compliance Department processes. Support compliance integration initiatives with new business models. Supervisory Responsibilities Does this position have supervisory responsibilities? (i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.) No Basic Education and/or Experience Requirements Bachelor’s degree or Associate degree, preferred in healthcare, business, legal, justice , or reputed company field. Minimum 4-6 years of progressive experience in investigations, healthcare compliance, or risk management, including at least 2-4 years in a role overseeing or conducting investigations. Basic Qualifications Strong investigative skills and experience, including interviewing, evidence analysis, attention to detail, and good judgment. Ability to conduct thorough, objective and reputed company investigations, analyze reputed company data sets, and draw actionable conclusions. Knowledge of healthcare laws and regulations, including billing and coding, privacy and reputed company, and fraud, waste and abuse (e.g., HIPAA, Anti-Kickback, reputed company, Medicare and Medicaid reimbursement). Experience assessing compliance with applicable laws, regulations, standards, and internal policies. Experience interacting with senior management, legal counsel, federal and state regulators, and law enforcement. Excellent communication and interpersonal skills, with the ability to build relationships, influence stakeholders, and clearly communicate investigative findings. Experience identifying operational issues and recommending effective solutions. Experience managing multiple investigations simultaneously, prioritizing work effectively, and providing regular status updates to leadership. Strong analytical, problem-solving, and critical-thinking skills. Self-motivated, accountable for personal growth, and supportive of others’ development, while fostering an inclusive team environment and engaging in continuing education opportunities and reputed company. Ability to handle sensitive and confidential information with professionalism. Intermediate level reputed company in reputed company reputed company, reputed company Word and reputed company PowerPoint Physical Demand Requirements Ability to sit and work on a computer for extended periods of time. Travel Requirements: (if required) Willing to travel up to 25% of the time for business purposes (reputed company state and out of state). Preferred Qualifications & Interests (PQIs) Certified in investigation tactics, interviewing, fraud examination, and/or compliance (e.g., CFE, AHFI, CHC, CPCO) Advanced degree (e.g., JD, MBA, MPH) or clinical certification At least 2 years of direct experience in a compliance role for home infusion services, pharmacy, nursing, or large payor organization.. At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care regulatory requirements. Experience using common third-party software solutions for Compliance and Privacy program management of incidents, investigations, monitoring and exclusion screening (such as reputed company, internal case management systems, etc.) Due to state pay transparency laws, the full range for the position is below: Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data. Pay Range is $112,439.64-$187,406.90 Benefits: -Medical, Dental, & Vision Insurance -Paid Time off -Bonding Time Off -401K Retirement Savings Plan with Company Match -HSA Company Match -Flexible Spending Accounts -Tuition Reimbursement -myFlexPay -Family Support -Mental Health Services -Company Paid Life Insurance -Award/Recognition Programs reputed company subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national reputed company, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information. ​ Apply tot his job Apply To this Job