Health Care Compliance Investigator, Senior Manager

Summary

Join Aledade as a Compliance Investigator and transform the compliance investigations function into a data-driven, risk-based program. Oversee and manage compliance investigations, establishing an Investigations Protocol with timing metrics. Conduct confidential investigations into potential compliance violations, analyze data to identify trends, and provide recommendations for corrective actions. This role requires a Bachelor’s degree and 8 years of compliance experience, including 5 years in healthcare. Aledade offers flexible work arrangements, including remote work options, and a comprehensive benefits package.

Requirements

• Bachelor’s degree
• 8 years of compliance experience; minimum 5 years of experience working in a health care organization and/or role
• Proven experience in a compliance investigator role within the health care industry, preferably in a technology-focused environment
• Excellent written and verbal communication skills, with the ability to present complex information clearly and concisely
• Strong understanding of health care regulations, including HIPAA, Stark Law, Anti-Kickback Statute, and other relevant regulations

Responsibilities

• Maintain an investigation policy and protocol
• Lead/Conduct thorough investigations into allegations of compliance violations, including but not limited to Fraud, Waste, and Abuse, Conflict of Interest, Anti-Kickback Statute (AKS), and other policy breaches
• Interview relevant personnel and examine documentation to assess compliance with laws, regulations, and company policies
• Collect, analyze, and interpret complex data related to compliance issues in order to identify trends and areas of improvement
• Prepare detailed reports outlining findings, conclusions, and recommendations for corrective actions or enhancements to the compliance program
• Report on material investigation finding to the Compliance Committee and the Board of Directors

Preferred Qualifications

• 2 years of direct, indirect and/or cross functional experience leading teams
• Experience with health care billing and coding
• Certified in Health care Compliance

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles
• Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners
• Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays
• 12 weeks paid Parental Leave for all new parents
• 6 weeks paid sabbatical after 6 years of service
• Educational Assistant Program & Clinical Employee Reimbursement Program
• 401(K) with up to 4% match
• Stock options