Manager of Compliance

Manager of Compliance
POSITION SUMMARY

The Manager of Compliance owns the performance of Kubat's PAP compliance function and the operating system used to keep patients appropriately engaged, monitored, documented, and eligible for reimbursable therapy and supply fulfillment. As compliance requirements have become an ongoing part of PAP patient management rather than a limited early-therapy activity, this role is responsible for building a disciplined, measurable department that identifies patients requiring action, intervenes early, improves adherence, maintains documentation integrity, and prevents avoidable revenue loss or patient disruption caused by missed compliance follow-through. The Manager leads the Compliance Specialists through clear goals, visible metrics, daily workload management, coaching, accountability, staffing decisions, process improvement, and close coordination with Patient Care Operations and other departments.
PRIMARY ACCOUNTABILITY

Own the compliance business result: build and lead a team that consistently identifies and acts on patients requiring compliance intervention, improves documented adherence, maintains accurate and timely compliance records, and protects patient continuity and reimbursable revenue through disciplined execution.
ROLE BOUNDARY

The Manager owns the department's daily and weekly execution, frontline performance, coaching, staffing, and process discipline. The Senior Director of Patient Care Operations owns broader Patient Care strategy and executive-level cross-functional decisions. Clinical decisions remain with appropriately licensed clinical personnel. The Manager is expected to recognize clinical or technical barriers and ensure they are escalated to the correct resource rather than allowing them to become unresolved compliance problems.
ESSENTIAL DUTIES & RESPONSIBILITIES
Compliance Performance System

• Establish and maintain the operating cadence for the department, including daily queue/pacing review, weekly performance review, and regular reporting to the Senior Director of Patient Care Operations.
• Define clear individual and team expectations for patient outreach, effective contacts, follow-up timeliness, unresolved case aging, documentation quality, and compliance outcomes.
• Create visibility into the entire compliance population, including patients who are compliant, approaching requirements, at risk, unresolved, or affecting pending supply fulfillment.
• Use dashboards, reports, work queues, and exception lists to identify problems early enough to act rather than explaining missed outcomes after the fact.
• Develop recovery plans when team production, patient compliance, queue aging, or documentation performance is below standard.

Frontline Leadership, Coaching & Accountability

• Lead, coach, and hold Compliance Specialists accountable for measurable individual performance and patient follow-through.
• Observe work, review calls and documentation when appropriate, diagnose performance gaps, provide direct coaching, and measure whether improvement occurs.
• Create a respectful, urgent, and accountable culture in which unresolved work has an owner and chronic underperformance is addressed promptly.
• Recognize strong performance and reinforce behaviors that improve patient adherence, documentation quality, and team productivity.
• Partner with Human Resources and the Senior Director on performance improvement plans, formal corrective action, recruiting, and timely personnel decisions when improvement does not occur.

Patient Population Management & Intervention Strategy

• Segment the compliance population so outreach intensity and priorities reflect patient risk, upcoming requirements, current adherence, unresolved barriers, and supply-order needs.
• Ensure staff intervene early with at-risk patients and use an appropriate, persistent follow-up cadence rather than allowing cases to age passively.
• Develop and refine outreach approaches, scripts, education tools, escalation paths, and workflow standards that improve patient engagement and documented compliance.
• Ensure clinical, equipment, mask-fit, physician, and other barriers are routed quickly to the right resource and tracked through resolution.
• Review difficult or high-impact cases and provide direction on escalation and next actions.

Documentation, Reimbursement Integrity & Audit Readiness

• Ensure compliance records and patient interactions are accurately and timely documented in designated systems.
• Ensure required compliance information and reports are submitted through established processes and can be retrieved when needed.
• Monitor for gaps that could create preventable reimbursement loss, delayed supply orders, rework, audit exposure, or patient disruption and drive corrective action.
• Support internal and external audit activity related to PAP compliance and ensure identified issues result in process improvement.
• Maintain a culture in which production is only successful when the underlying documentation and payer requirements are satisfied.

Analytics, Process Improvement & Cross-Functional Leadership

• Analyze compliance trends, patient barriers, contact effectiveness, queue aging, staffing productivity, and other data to identify the highest-value opportunities for improvement.
• Evaluate staffing levels, work allocation, workflows, technology, and training needs and recommend changes that improve results.
• Partner closely with the Senior Director of Patient Care Operations and with Respiratory, Resupply, Intake, Billing, Customer Service, Clinical, IT, and Finance to resolve barriers that cross departmental lines.
• Communicate department performance, risks, trends, and required decisions clearly and concisely to leadership.
• Build a capable leadership bench and identify employees who can take on greater responsibility as the department grows.

PERFORMANCE MEASURES

• Overall documented PAP compliance performance and trend for the managed patient population.
• Percentage and aging of at-risk, noncompliant, or unresolved patients requiring action.
• Team outreach productivity, effective contact rate, and timeliness of intervention/follow-up.
• Improvement or conversion of patients from at-risk/noncompliant status to documented compliance.
• Compliance documentation accuracy, completeness, and audit readiness.
• Preventable reimbursement loss, supply-order disruption, rework, or delay associated with compliance follow-through or documentation gaps.
• Individual Specialist productivity and performance distribution; timely improvement or resolution of sustained underperformance.
• Strength, stability, and scalability of department workflows, staffing, and leadership capability.

QUALIFICATIONS
Required

• Demonstrated success leading a metric-driven frontline team in patient engagement, contact-center operations, customer retention, collections, claims, case management, revenue-cycle support, or a comparable high-volume environment.
• Proven accountability for quantified team goals and a record of improving performance through coaching, workload management, process changes, and timely personnel decisions.
• Strong ability to manage an assigned population or queue using segmentation, aging, prioritization, exception management, and visible performance data.
• Comfort holding people accountable for both productivity and quality; unwillingness to trade documentation or compliance integrity for superficial volume.
• Strong analytical, organizational, communication, and problem-solving skills.
• Ability to learn PAP therapy, payer compliance, reimbursement, privacy, and documentation requirements well enough to manage the function effectively and identify risk.
• Ability to work cross-functionally and escalate clinical or technical issues to appropriate professionals while maintaining ownership of operational follow-through.

Preferred

• Healthcare, DME/HME, respiratory, sleep medicine, specialty pharmacy, patient adherence, chronic-care engagement, payer, or other regulated-industry experience.
• Experience using adherence, retention, collections, claims, or patient-engagement data to segment a population and direct interventions.
• Working knowledge of PAP therapy, sleep-disordered breathing, Medicare/Medicaid/commercial payer requirements, or healthcare reimbursement.
• Experience with Brightree, PAP monitoring platforms, CRM/EMR systems, contact-center tools, or comparable workflow technology.
• Experience leading a turnaround, resetting performance expectations, or building a new operating cadence in an underperforming team.

KEY COMPETENCIES

Performance Leadership • Accountability • Coaching • Patient Engagement Strategy • Data-Driven Management • Population Management • Urgency • Reimbursement Awareness • Process Discipline • Change Leadership • Cross-Functional Influence • Compliance Judgment

KUBAT HEALTH CARE IS AN EQUAL OPPORTUNITY EMPLOYER

The statements herein describe the general nature and level of work performed and are not an exhaustive list of duties, responsibilities, or qualifications. Duties may be changed, expanded, reduced, or delegated based on business needs.