Description
Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states.
We are now hiring a skilled Compliance Manager in Princeton, NJ . The Compliance Manager is responsible for the supervision of the compliance specialists ensuring internal monitoring and audits to evaluate the COI’s compliance with requirements and overall effectiveness of the Corporate Compliance Program. This includes the monitoring and auditing of billing records using the federal and state regulations meeting Center for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS), and the Office of Inspector General (OIG) guidelines to identify potential overpayments. This role requires a unique blend of compliance expertise and analytical skills to monitor, assess, and optimize compliance processes using data-driven insights.
Starting Salary : $75,000- $80,00 annually based on experience
Responsibilities
- Oversee auditing and monitoring schedules and activities for Compliance Specialists
- Maintain current knowledge of internal audit techniques and best practices
- Review internal and external audits of claim reviews ensuring appropriate documentation
- Conduct internal audits and follow-up validations of internal processes
- Identify areas of risk and provide recommendations for mitigation
- Complete audit reports by documenting the audit plan, risks, tests, findings, recommendations, executive summary, and validation
- Conduct comprehensive record reviews
- Investigate reports of non-compliance and provide comprehensive reports with recommendations
- Submit regular reports and communicate findings to the Director of Data Analytics
- Recommend any necessary changes in current policy and procedures
- Maintain a master file of all audits
Minimum Requirements
Bachelor’s degree in healthcare administration, accounting, or a related field and three years of relevant experienceCertification as CHC, CHRC, or CHPC preferredValid driver’s license with a satisfactory driving recordExperience with billing practices and guidelinesUnderstanding of CMS, HHS, and OIG regulationsAbility to present facts and recommendations effectively in oral and written formIndependent judgment is required to plan, prioritize, and organize a diversified workloadAbility to demonstrate poise, tact, and diplomacyExcellent presentation and verbal skillsAnalyze large data sets from multiple sources to identify compliance trends, gaps, and areas of improvement.Strong proficiency in Microsoft Office, particularly ExcelProficiency in data analysis tools and business intelligence platforms (e.g., Tableau, Power BI).Knowledge and understanding of local regulatory agency operationsEmployment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testingWhy Community Options?
Competitive Insurance Benefits (Medical, Dental, Vision)Paid Holidays—Including a Birthday HolidayGenerous PTOEmployee Incentive & Discount Programs403b Retirement PlanIncredible career growth opportunitiesUniversity partnerships that include tuition reductionCommunity Options is an Equal Opportunity Employer M / F / D / V
#IND-NA