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OpenLoop is a telehealth platform that streamlines virtual care delivery across all 50 states. As Healthcare Investigations Manager, you will own the end-to-end intake, triage, and investigation of reports from OpenLoop's newly launched compliance hotline, which went live two weeks ago and is already generating cases. You will report to the Sr. Director of Clinical Compliance and manage 2 direct reports.
Key responsibilities include: conducting thorough investigations of reported concerns while gathering facts, interpreting policy, and analyzing data with discretion; owning the response and corrective-action workflow from findings through closure and documentation; investigating potential HIPAA and Security Policy violations in coordination with IT Security; conducting monthly and new-vendor exclusion screenings against federal and state exclusion lists; coordinating self-disclosures and escalations with Legal and compliance leadership; preparing quarterly investigation and disclosure-program reports for senior leadership and the Compliance Committee/Board; serving as system administrator for the compliance case-management and exclusion-screening platform(s); and managing and developing your team as hotline volume scales.
You should have full-time experience running a healthcare investigations or hotline function in a compliance or regulatory setting, with direct hands-on experience investigating HIPAA/Security Policy violations ideally in coordination with IT Security teams. You need hands-on experience administering a compliance case-management or hotline platform, strong root-cause analysis and audit-ready documentation discipline, and familiarity with OIG guidance (Elements 4 and 7). You are comfortable preparing and presenting investigation trends and disclosure-program data to senior leadership, conducting policy gap analysis, and working with leaders to implement changes. A CHC (Certified in Healthcare Compliance) certification is preferred. You are a high-integrity, low-ego collaborator comfortable managing a small team while staying hands-on with casework in an early-stage build phase.
