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Clinical Compliance Leader - Medicare & SNP Programs

Monogram Health

Position: Clinical Compliance Manager Monogram Health is looking for a Clinical Compliance Manager to support and enhance our Compliance Program through oversight, risk assessment, and cross-functional collaboration. This role provides critical compliance guidance and leads certain monitoring and audit activities. Reporting to the Senior Director of Compliance, this position is key to driving a strong culture of compliance and ethical practice across the organization. Hybrid position preferred in either the Tempe AZ or Brentwood TN office location. Responsibilities Lead, administer, and continuously improve key components of the Compliance Program to support organizational objectives. Conduct compliance oversight activities, including monitoring and auditing, to assess adherence to regulatory requirements (e.g., CMS) and contractual obligations. Drive and support compliance risk assessments, as well as work plan development and implementation, aligning enterprise priorities with regulatory expectations. Serve as a primary liaison internally for assigned compliance activities, including audits, inquiries, etc. as tied to the annual risk assessment and compliance workplan. Provide subject matter expertise and strategic guidance to cross-functional teams on compliance matters, including interpretation and implementation of regulatory and contractual requirements. Collaborate with operational leaders to develop, review, and update policies and procedures in connection with completed compliance audit and monitoring activities. Develop and deliver reports and presentations on compliance activities, including audit and monitoring results to leadership and stakeholders. Lead or contribute to compliance-related projects, initiatives, and research to support program effectiveness and regulatory readiness. Conduct internal investigations related to concerns reported via the Compliance & Ethics Helpline or directly to the Compliance team; ensure proper documentation, tracking, and reporting. Position Requirements Bachelor’s degree in healthcare, nursing, legal studies, or a related field, or equivalent combination of education and relevant experience. Minimum of five (5) years of experience in Medicare Managed Care, with preferred expertise in Special Needs Plan Model of Care (SNP MOC) requirements, including D-SNP and C-SNP with at least three (3) years of leadership or supervisory experience, with demonstrated ability to influence and guide cross-functional teams. Active, unrestricted Registered Nurse (RN) license required. Certified in Healthcare Compliance (CHC) preferred (or willingness to obtain certification within a defined timeframe). Extensive knowledge of Medicare and Medicaid compliance programs, including applicable regulatory frameworks and audit expectations. Influencing and stakeholder management skills, with the ability to build trust and drive alignment across cross-functional teams. Written and verbal communication skills, including the ability to translate complex regulatory requirements into clear, actionable guidance for diverse audiences. Critical thinking and risk-based decision-making skills, with the ability to assess compliance risks and recommend practical, business-aligned solutions. Integrity and ethical judgment, with a commitment to fostering a culture of accountability, transparency, and compliance. Benefits Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.

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Vacancy posted 5 days ago
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