Compliance Manager - (US-TN-Nashville - 37250)

Minimum Education: None
Job Type: Full Time
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Responsibilities : Responsible for ensuring compliance with governmental requirements. Develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed. Coordinates and manages the development, approval, and implementation of the Company's fraud protection and prevention programs.. SkillsEstablishes program governance when needed to assure response to issue escalation; develop program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day-to-day business issues; researches applicable subject matter practices and remains aware of industry trends; manages relationships with partners both internal and external; coordinates training related programs; develops program success measures and performs periodic assessments of program success..

Requirements :Bachelor's degree in Business, Clinical, Criminal Justice, or related field; working knowledge of medical terminology and experience reviewing medical records; strong oral and written communications skills; Six or more years of related experience. For SIU unit, minimum five years of related experience as an investigator with exposure to the healthcare industry; claims-related experience including strong working knowledge of coding, fee and reimbursement and claims processing policies and procedures.

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