Healthcare Investigations Manager

About the Role

OpenLoop's compliance hotline went live two weeks ago and is already generating reports. As Healthcare Investigations Manager , you'll own intake, triage, and investigation of hotline reports from day one — building the structure this function needs as OpenLoop scales. You'll report to the Sr. Director, Clinical Compliance , with 2 direct reports already in seat.

What You'll Do

• Intake & Triage: Own intake, triage & investigation of hotline reports; assign cases to team members based on expertise and capacity, with clear guidance on investigation procedures and standards.

• Investigation Execution: Conduct thorough investigations of reported concerns — gathering facts, interpreting policy, analyzing data, and handling sensitive matters with discretion; recognize when escalation is necessary.

• Response & Remediation: Own the response and corrective-action workflow — define findings, drive remediation, confirm closure, and document investigative steps through resolution. Own Policy Gap analysis .

• HIPAA & Security Investigations: Investigate potential HIPAA and Security Policy violations, coordinating with IT Security on related reporting and remediation.

• Exclusion Screening: Conduct monthly and new-vendor exclusion screenings against federal and state exclusion lists to mitigate organizational risk.

• Self-Disclosure Coordination: Coordinate self-disclosures & escalations with Legal and compliance leadership.

• Board & Committee Reporting: Prepare quarterly investigation and disclosure-program reports for senior leadership and the Compliance Committee/Board , identifying trends and supporting risk-assessment discussions.

• Systems Administration: Serve as system administrator for the compliance case-management and exclusion-screening platform(s), managing configuration, user access, and data integrity.

• Regulatory Alignment: OIG E7 · Response | OIG E4 · Reporting

• Team Leadership: Manage and develop 2-3 direct reports ; build capacity as hotline volume scales.

• Other duties as assigned.

Who You Are

• Experience running a healthcare investigations or hotline function full-time, ideally in a compliance or regulatory setting.

• Direct experience investigating HIPAA/Security Policy violations, ideally in coordination with an IT Security team.

• Hands-on experience administering a compliance case-management or hotline platform.

• Comfortable preparing and presenting investigation trends and disclosure-program data to senior leadership.

• Strong root-cause analysis and audit-ready documentation discipline.

• Strong Policy gap analysis and working with leaders to implement changes.

• Familiarity with OIG guidance , particularly Elements 4 and 7 .

• Comfortable managing a small team while staying hands-on with casework, especially in an early build phase.

• CHC (Certified in Healthcare Compliance) preferred.

• High integrity, low-ego collaborator across Legal , Compliance , IT Security , and Operations .