Compliance Manager

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 Pittsburgh, PA . 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 : $80,000 / per year

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

Why Community Options?

Community Options is an Equal Opportunity Employer M / F / D / V

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