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Salary: USD 132,000 - 175,000 / annual
Habitat Health is a healthcare organization that delivers comprehensive medical care and support services to older adults through the Program of All-Inclusive Care for the Elderly (PACE). The company is expanding rapidly with backing from leading investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures.
The Compliance Manager reports directly to the VP of Compliance and plays a key role in ensuring successful outcomes for Centers for Medicaid & Medicare Services (CMS) and State Administering Agency (SAA) audits while fostering a culture of compliance across the organization.
Key responsibilities include:
- Leading audit readiness activities for CMS and SAA audits, including internal monitoring of audit universe data (medical records), staff training, policy/procedure reviews, and process improvements
- Managing live audits by serving as the primary point of contact with CMS and SAA audit teams, ensuring submission quality assurance, and developing, approving, and monitoring corrective action plans
- Developing expertise on PACE audit data, trends, best practices, and risk mitigation strategies; providing guidance on audit-related questions and supporting business development efforts
- Preparing regular audit-related reporting and metrics for the Chief Medical Officer, Executive Compliance Committee, and Board compliance subcommittee
- Recommending updates to the Compliance Department's annual auditing and monitoring workplan based on audit findings and regulatory trends
- Collaborating with Population Health and Practice Operations teams on audit impacts to quality improvement and center operations
- Representing the compliance program across the organization, building relationships with staff at all levels, and championing compliance initiatives
- Traveling as needed to support regulatory audits (up to 30% during peak times)
The role is fully remote with the flexibility to work from anywhere in the US, though travel to audit sites will be required periodically.
REQUIREMENTS:
- Minimum 3 years of experience in healthcare audit or related field
- Active and unrestricted Registered Nurse (RN) license
- Experience in PACE compliance (highly preferred)
- Ability to lead with influence and work effectively in fast-paced environments
- Strong organizational skills, attention to detail, and ability to manage multiple projects
- Excellent data interpretation and analysis skills with ability to make data-based recommendations
- Strong interpersonal, verbal, and written communication skills
- Proficiency with Microsoft 365 suite
- Ability to identify opportunities for internal and external collaboration
NICE TO HAVES:
- Bachelor's degree in healthcare administration, public health, healthcare operations, public policy, or clinical field
- Certified in Healthcare Compliance (CHC)
- Experience with DHCS and/or CMS
- Working knowledge of Epic
- Experience developing or delivering compliance training to adult learners
