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Compliance Manager
Medical Guardian. Design, implement, and maintain a comprehensive compliance program meeting state and federal requirements, including Medicaid, Medicare, and HIPAA regulations .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing and maintaining compliance programs that adhere to Medicaid, Medicare, and HIPAA regulations, while effectively managing compliance risks and conducting audits. Possesses strong project management and communication skills to lead compliance initiatives and educate stakeholders across the organization.
Highest-signal resume keywords
Healthcare ComplianceMedicaid RegulationsMedicare RegulationsHIPAA ComplianceProject Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
AuditingRisk ManagementCompliance Program DevelopmentPolicy DevelopmentInternal Audit Planning
Soft Skills
Excellent CommunicationAnalytical SkillsProblem-SolvingEthical StandardsStakeholder Education
Tools & Technologies
Microsoft Office SuiteCompliance SoftwareHealthcare IT CompliancePersonal Emergency Response Systems (PERS)
Industry Keywords
Compliance FrameworkCorrective Action Plans (CAPs)Protected Health Information (PHI)Compliance DocumentationRegulatory Changes
About the role
Key responsibilities & impact- Design, implement, and maintain a comprehensive compliance program meeting state and federal requirements, including Medicaid, Medicare, and HIPAA regulations
- Develop and update policies and procedures to reflect regulatory changes
- Create a compliance framework integrating training, documentation, monitoring, and enforcement mechanisms
- Develop and execute internal audit plans
- Identify compliance risks, conduct assessments, and recommend corrective actions
- Manage and oversee Corrective Action Plans (CAPs)
- Ensure company-wide adherence to HIPAA privacy and security standards related to Protected Health Information (PHI)
- Monitor activities, investigate potential violations, and enforce corrective actions
- Collaborate with IT and operations teams regarding PERS-related healthcare systems and technology
- Provide ongoing compliance training and educate internal stakeholders, including executive leadership
- Lead compliance-driven projects involving product launches, IT implementations, organizational processes, and contracts
- Partner with legal, operations, and IT teams on compliance for new initiatives and contracts
- Maintain compliance documentation, including policies, audit results, risk assessments, and corrective action plans
- Prepare regular compliance reports for executive leadership
- Perform other duties as assigned
Requirements
What you’ll need- Bachelor’s degree in healthcare administration, Business, Law, or a related field
- Minimum of 5 years of experience in healthcare compliance, with a focus on Medicaid, Medicare, and HIPAA regulations
- Demonstrated experience in auditing, monitoring, and risk management within a healthcare environment
- Strong understanding of state and federal Medicaid/Medicare programs, HIPAA regulations, and healthcare compliance enforcement
- Experience with personal emergency response systems (PERS) and healthcare IT compliance
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and compliance software tools
- Exceptional project management skills, with the ability to manage multiple initiatives simultaneously
- Excellent verbal and written communication skills, with the ability to educate and influence stakeholders at all organizational levels
- Strong analytical skills with the ability to assess complex regulations and identify actionable solutions
- High ethical standards, confidentiality, and a strong commitment to compliance integrity
- Proactive problem-solving mindset and ability to work independently under tight deadlines
- Ability to thrive in a dynamic, fast-paced environment with a focus on delivering results
Benefits
Comp & perks- Health Care Plan (Medical, Dental & Vision)
- Paid Time Off (Vacation, Sick Time Off & Holidays)
- Company Paid Short Term Disability and Life Insurance
- Retirement Plan (401k) with Company Match