Compliance Manager

Compliance Manager

Requirements

• Bachelor’s degree in Public Administration, Business Administration, Organizational Development, Compliance, or a related field preferred. Additional relevant experience may be substituted for a degree.
• Minimum of three (3) years of experience in compliance, private sector, State and Federal health policy, fiscal oversight, grant management, contract negotiations, or quality assurance in a supervisory or administrative capacity.
• Background and experience in regulatory compliance related to private, State, and Federal funding regulations.
• Experience in program development, financial tracking, budget analysis, and contract compliance within a government or nonprofit setting.
• Experience with data analysis and working with metrics to determine program effectiveness.
• Experience managing contracts, overseeing program budgets, and ensuring financial compliance.
• Ability to develop policies and procedures, conduct risk assessments, and lead compliance training.
• Demonstrated ability to integrate diversity, equity, and inclusion (DEI) principles into compliance programs.
• Familiarity with contract negotiations and vendor compliance oversight.
• Demonstrate cultural awareness and sensitivity and an ability to work effectively with culturally diverse populations.

Responsibilities

• Develop and implement compliance policies and procedures in alignment with federal, state, and local laws, including, but not limited to, HIPAA, Medicaid/Medi-Cal, the Lanterman Act, service contracts, memoranda with partners, service agreements, contracts with DDS, etc.
• Identify, assess and mitigate compliance risks and report on activities to management.
• Serve as liaison with regulatory agencies to ensure compliance with California Public Records Act (PRA) requests, whistleblower 4731 Complaint reports, and contractual obligations; and develop and maintain document retention policies.
• Assess gaps in organizational compliance and create and deliver appropriate training to educate employees.
• Investigate potential compliance violations, and implement appropriate corrective action.
• Oversee and track regulatory reporting processes, facilitating communication with RCEB and oversight agencies.
• Liaise with insurance and coordinate responses and retain necessary documentation for litigation within the required time period.
• Maintain secure and effective whistleblower reporting systems, ensuring confidentiality and protection from retaliation.
• Lead security awareness initiatives to protect sensitive information and ensure best practices are followed across the organization.
• Assist in the performance contract development and monitoring with DDS.
• Perform other duties as assigned.
• Lead HIPAA, Risk, Security and ad hoc compliance audits, risk assessments, and compliance evaluations to identify vulnerabilities and recommend corrective actions.
• Oversee fraud prevention strategies and confidential reporting mechanisms, ensuring protections for whistleblowers.
• Ensure contract monitoring and program financial recommendations to mitigate risks associated with improper fund allocations and/or regulatory violations.
• Conduct and oversee investigations related to regulatory violations, contract breaches, and non-compliance issues.
• Maintain detailed records of compliance concerns and ensure timely resolution.
• Ensure HIPAA compliance related to data privacy, security, and breach reporting.
• Collaborate with IT and administration to enhance security awareness and protect electronic records.
• Develop and conduct training programs related to HIPAA and contract development and monitoring to promote compliance and ethical practices across RCEB.

Preferred Qualifications

• Additional relevant experience may be substituted for a degree.