Compliance Manager

Description

Job Summary: 

The Compliance Manager is responsible for ensuring that all healthcare providers within the practice adhere to established clinical, regulatory, and organizational standards. Working closely with the Chief Medical Officer (CMO), this role monitors provider activities, identifies potential compliance risks, and supports the development and enforcement of policies that promote safe, ethical, and compliant medical practice.

The Compliance Manager serves as a key partner in maintaining high-quality patient care while ensuring that providers follow required protocols, documentation standards, and regulatory obligations.

Job Duties and Responsibilities:

Key Responsibilities

• Collaborate with the Chief Medical Officer to develop, update, and enforce compliance policies and procedures.
• Monitor provider performance and clinical practices to ensure alignment with internal standards, accreditation requirements, and applicable laws.
• Review clinical documentation, workflows, and practice patterns to identify gaps or deviations from expected practice.
• Conduct routine audits and targeted reviews of provider activities.
• Provide feedback, coaching, and corrective action guidance to providers when compliance issues arise.
• Investigate compliance concerns, incidents, or potential deviations; document findings and recommend solutions.
• Serve as a resource for providers regarding compliance expectations and best practices.
• Support training initiatives related to compliance, documentation, and regulatory updates.
• Maintain accurate records of audits, investigations, and compliance activities.
• Participate in multidisciplinary meetings with leadership, including the CMO, to address compliance trends and improvement opportunities.
• Assist in preparing for external audits, inspections, and accreditation reviews.
• Other duties as assigned. 

Requirements

Qualifications and Experience:

• Bachelor’s degree in Healthcare Administration, Nursing, Public Health, Compliance, or related field (Master’s preferred).
• Minimum 3–5 years of experience in healthcare compliance, clinical operations, or quality assurance.
• Strong understanding of healthcare regulations, clinical documentation standards, and provider workflows.
• Ability to review clinical material and identify compliance concerns, even without a clinical license.
• Excellent communication skills, with the ability to provide constructive feedback to clinicians.
• Detail-oriented with strong analytical and problem-solving capabilities.
• Ability to work collaboratively with leadership and clinical staff.
• Certification (CHC, CCEP, CPPS, or similar) preferred but not required.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The individual will be required to:

• Sit for long periods at a time.
• Use hands and fingers in repetitive motions, daily.
• Ability to lift, push and pull up to 20 lbs. periodically.
• Travel to clinic locations or sites as needed.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.