Job Category
Finance, Legal & Compliance
Job Type
Professional
Employment Type
Direct Hire
Work Hours
Full-time
Compensation
$120,000 − $150,000per year
This job was last updated on
Job Summary
Our client is seeking a Senior Health Care Compliance Manager to oversee corporate regulatory compliance, internal policy adherence, quality assurance/quality improvement initiatives, and accreditation activities. This position reports directly to the Head of Commercial Operations and plays a key role in maintaining organizational excellence and compliance across all divisions.
Here's What Your Day-to-Day Looks Like
- Ensure compliance with all applicable federal and state regulations, including ERISA, HIPAA, MHPAEA, and ACA.
- Serve as liaison with healthcare attorneys on legislative and regulatory matters; recommend and implement policy changes as needed.
- Manage corporate licensing requirements and oversee related audits and board meetings.
- Develop client-specific NQTL analyses and maintain corporate reporting.
- Oversee corporate complaints and appeals processes, including Federal External Reviews and Appeal Committee meetings.
- Conduct staff orientation and compliance training; provide ongoing guidance on quality assurance and regulatory requirements.
- Maintain all state licensing, certification, and registration filings, including name and trademark registrations.
- Assist in the development and updating of clients’ benefit plan documents (SPDs, SBCs) to ensure compliance with federal regulations.
- Oversee corporate accreditation processes and quality assurance programs.
- Conduct divisional quality audits, including patient chart audits, and utilize findings to improve care management and service delivery.
- Oversee patient satisfaction survey responses and assist in maintaining high satisfaction ratings.
- Serve as corporate liaison for subpoenas, lawsuits, or complaints filed against the organization.
Schedule & Pay
- Schedule: Monday–Friday, 8:00 AM – 5:00 PM
- Onsite | Full-Time
- Salary: $120,000 – $150,000
- Potential Bonus: up to $8,000 - $10,000
Here's What Makes YOU a Great Fit
- Juris Doctor (JD) degree with advanced degree in clinical counseling.
- 5+ years’ quality assurance experience.
- Experience in managed care/PPO environment and case management/utilization review.
- Proficiency in Microsoft Office Suite.
- Strong communication, organization, and problem-solving skills.
- Proven experience in staff supervision, training, and group presentations.
Job Location
Birmingham, Alabama
Benefits
- Medical, Dental & Vision: Comprehensive coverage through Blue Cross Blue Shield and VSP, with company contributions toward premiums. Eligibility begins the 1st of the month following hire.
- Employee Assistance Program (EAP): Up to three free mental health sessions per year for employees, spouses, and dependents (up to age 26).
- Life & Voluntary Insurance: Company-paid life insurance (1x annual income, up to $200K) and options for supplemental life, short-term, long-term, and critical illness coverage. Eligibility typically after 6 months.
- Retirement: 401(k) plan with company match (100% up to 3%, 50% up to 2%) after probationary period.
Paid Time Off
- Vacation: 2–6 weeks, based on role and years of service.
- Sick Days: 8 days, accrued from first day.
- Holidays: 9 recognized holidays per year.
- Personal Days: 2 per year, available immediately.
Company Website
Company Size
251-1000