"Regulatory Compliance Manager - Hybrid/Remote"

Regulatory Compliance Manager - Hybrid/Remote

Job Summary

Ensures patient billing practices conform to government reimbursement guidelines by monitoring current practices, managing and documenting audit processes, developing and implementing systems to track compliance activities and providing compliance education.

Responsibilities

Essential Functions

• Supports Compliance Administrator in policy review and creation.
• Monitors and assists in drafting required documentation related to compliance processes.
• Works to identify trends, issues, and risk areas while giving details and improvement recommendations.
• Participates in creation, monitoring, and updates of educational and training programs to enhance compliance and awareness of compliance issues.
• Maintains current knowledge regarding federal and state guidance, organizational needs, and regulations. Serves as an expert resource in issue resolution.
• Collaborates with faculty and staff to assist departments to implement compliance practices. Coordinates with departments to monitor compliance activities.
• Conducts audits/investigations to ensure compliance with University, state and federal guidelines.

Problem Solving

Incumbent is responsible for assisting the University in preparation for regulatory audits by developing, monitoring and updating quality controls and recommending actions to maintain compliance. This position is the primary contact and expert regarding regulatory agency standards governing healthcare program requirements.

Representative challenges of this position include determining the validity of collected data, assessing process shortfalls, and developing effective safeguards to reduce risk. The incumbent must possess the ability to foster collaborative working relationships with a wide range of constituencies.

Work Environment and Level of Frequency typically required

Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required

Nearly Continuously: Sitting, hearing, listening, talking. Often: Repetitive hand motion (such as typing), walking. Seldom: Bending, reaching overhead.

Minimum Qualifications

Bachelor's degree in Health Care Administration, Business Administration or a related field or equivalency (one year of education can be substituted for two years of related work experience). Five years regulatory or administrative law experience, with at least three of those years in a health care setting or equivalency; coding certification (CPC, ACS, CCS-P/H, RHIA); knowledge of medical auditing, Federal healthcare program policies and requirements (including Medicare Parts A and B), and ICD-10, CPT, HCPCS, DRG coding; proficient with word processing, spreadsheet and related computer applications; demonstrated human relations and effective communication skills also required.

Knowledge of utilization review and quality assurance procedures is preferred. An understanding of University operations, policies and technology is preferred. Training or teaching experience is also preferred.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Preferences

Bachelor's degree in Health Care Administration, Business Administration or a related field or equivalency (one year of education can be substituted for two years of related work experience). Five years regulatory or administrative law experience, with at least three of those years in a health care setting or equivalency; coding certification (CPC, ACS, CCS-P/H, RHIA); knowledge of medical auditing, Federal healthcare program policies and requirements (including Medicare Parts A and B), and ICD-10, CPT, HCPCS, DRG coding; proficient with word processing, spreadsheet and related computer applications; demonstrated human relations and effective communication skills also required.

Knowledge of utilization review and quality assurance procedures is preferred. An understanding of University operations, policies and technology is preferred. Training or teaching experience is also preferred.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Special Instructions

Writing and competency test will be requested.

Requisition Number: PRN43595B
Full Time or Part Time? Full Time
Work Schedule Summary: Hybrid schedule.
Department: 01663 - COMPLIANCE SERVICES
Location: Campus
Pay Rate Range: $47,600-$70,000
Close Date: 2/13/2026