Compliance Manager

Compliance Manager

111 Michigan Avenue Northwest Washington, DC 20010

Kids Are Our Everything.

Pay Range: $103,812.80 - $173,035.20

This is a hybrid position that will report to and work out of the Vermont Avenue DC location for Health Services for Child with Special Needs.

About the Role:

The Compliance Manager assists and supports the Compliance Department functions and responsibilities of the organization to include but not limited to compliance training and communications, auditing and monitoring, compliance investigations and resolution plans, compliance risk assessment and controls framework, including the design and implementation of key risk indicators, assessing new tool/system implementations, and evaluating processes and controls, policy and procedure development, prevention of fraud waste and abuse, ensuring compliance with regulatory requirements including privacy and security, and sanctions screening.

The Compliance Manager is responsible for daily operational functions of the core elements of the organization's compliance functions and work with Compliance Department on matters needing escalation and resolution. The Compliance Manager also assists the Compliance Officer in preparing for the Compliance Management Committee and Board Audit Risk and Compliance Committee. The Compliance Manager needs to be able to interface cross-functionally across the organization.

What You'll Bring:

Minimum Education:

• Bachelor's Degree (Required)
• Master's Degree in health law, health administration or business administration (Preferred)

Minimum Work Experience:

• 5 years experience in healthcare compliance, healthcare operations or related (Required)
• Managed care experience (Preferred)

Required Skills/Knowledge:

• Knowledge of federal healthcare program laws and regulations

Required Licenses and Certifications:

• Certified Healthcare Compliance 1 Year (Required)

Functional Accountabilities

• Healthcare Compliance
• Maintain a working knowledge of relevant laws, rules, and regulations governing the healthcare services and clinical practice.
• Stay current on relevant industry and government compliance program guidance, investigations, and audit; stay abreast of and provide updates regarding changes in legislation, regulations and other requirements that may result in organizational response.
• Provide management of compliance, quality and standards projects within various business operations.
• Develop initial interpretation of relevant regulations and guidelines and act as a regulatory subject matter expert (SME) for business operations including responding to questions and concerns.
• Develop expertise and perform research in compliance and issues as requested.
• Support the development and management of the various compliance programs, such as policy and education, pharmacy, conflict of interest, research, and physician compliance program.
• Assist business with inspections, regulatory responses and consult on root cause analysis, as required.
• Conduct and perform compliance related activities, including audits, risk assessments, and other identified compliance activities, in support of the Compliance Workplan.
• Coordinate implementation of overall Compliance Workplan and Code of Conduct; consult and provide guidance on a regular basis on related issues with operations directors/managers to ensure conformance with applicable laws and regulations.
• Develop materials in support of the Compliance Management Committee and related work groups.
• Assist in periodic reviews and revisions of the Compliance policies and procedures.
• Assist the Compliance Officer with other department activities, as assigned.
• Internal Investigations & Reviews
• Conduct and document investigations in accordance with applicable legal requirements and organizational policies and procedures.
• Upon completion of investigation, ensure completion of corrective actions plans.
• Conduct assessments, document results, and oversee mitigation efforts implemented to reduce or eliminate risk/issues.
• Compliance Education & Training
• Support the compliance training programs on a day-to-day basis, ensuring timely completion of on-boarding and topic specific training and education by the workforce.
• Prepare and develop education materials.
• Provide compliance educational and training as needed.
• In partnership with the Legal Department, serve as a subject matter resource and provide consultation services regarding the application and implementation of current legal requirements and organizational policies and procedures.
• Auditing & Monitoring
• Identification of healthcare focus areas by the OIG and other regulatory bodies to assist in forming the compliance audit and monitoring work plan.
• Development and implementation of risk assessments and audits; capture and monitor corrective action plans until resolution.
• Perform auditing and monitoring to ensure compliance with all federal, state & local regulations, as well as fiduciary requirements, and identify areas of vulnerability and risk.

Benefits That Support You:

• Comprehensive health coverage, including medical, prescription, infertility, and transgender health services.
• Generous paid time off, including vacation accrual from day one, sick leave, holidays, and a personal day.
• Financial wellness support, including a 401(k) plan and healthcare and dependent care spending accounts.
• Employer-paid life, AD&D, and long-term disability coverage, with optional supplemental plans.
• Additional perks, including tuition assistance, fitness resources, employee assistance, commuter benefits, and more.

Why Join Us:

• Nationally Recognized Excellence Consistently ranked among the Top 10 Children's Hospitals in the nation by U.S. News & World Report.
• Leading Pediatric Care One of the largest and most comprehensive children's hospitals in the country, offering nationally ranked specialties and cutting-edge treatments.
• Innovation & Research A premier academic medical center with a strong commitment to pediatric research, education, and advancing the future of child health.
• Mission-Driven Culture Dedicated to providing family-centered care while fostering a collaborative, supportive environment for clinical teams.

Children's National Medical Center