Manager, Compliance and Regulatory Affairs

About the Role

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families.

We are an empowered primary care team, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well-being of the seniors we serve.

Our Culture & Core Beliefs

We earn trust, build relationships, create joy, do right, improve every day, and move forward. Our promise includes a purpose-driven career, competitive pay, best-in-class medical/dental coverage, free mental health & life coaching for team members and their dependents, holiday time off with pay, paid community service day, paid parental/family leave, paid bereavement leave, generous paid time off (PTO), 401k retirement plan with company match, and more.

Responsibilities

The Manager, Compliance and Regulatory Affairs reports to the AVP, Legal & Compliance and has a key role in supporting the implementation of the seven elements of an effective compliance and helping promote the Company's vision, mission, and culture.

• Manage organization’s healthcare compliance program and support ongoing compliance strategic planning
• Perform internal audits and monitor operational practices to identify compliance risks
• Monitor compliance with applicable regulations, including HIPAA, Medicare, Medicaid, CMS, OIG guidance, Stark Law, Anti-Kickback Statue and other healthcare regulations
• Collaborate with department leaders to implement corrective actions and monitor their effectiveness
• Investigate reported compliance concerns, violations, and potential fraud, waste, or abuse
• Supervise and manage Regulatory Compliance team roles as assigned
• Develop and deliver compliance education and training programs for employees, providers and leadership
• Conduct risk assessments, maintain documentation related to compliance activities, investigation and regulatory inquiries
• Coordinate system projects by partnering with accountable business owners and proactively lead efforts to mitigate risks associated with business activities
• Create, modify, update and implement company compliance policies and chair the company's Policy Committee
• Proactively develop risk management strategies for known, unknown and/or anticipated company risks
• Lead risk audits; identify risk and/or noncompliance areas and produce actionable, data-driven reports
• Monitor regulatory changes and communicate new requirements throughout the organization
• Coordinate Root Cause Analyses when indicated and proactively share data, risk management trends and educate stakeholders
• Promote ethical decision-making and maintain confidential reporting mechanisms
• Provide simple contract review support, analysis and oversight

Requirements

• Bachelor's Degree required
• Master’s degree in Healthcare Administration, Business Administration, Public Health or a related field in healthcare legal preferred
• Certification in Healthcare Compliance (CHC) preferred

Qualifications

• 5+ years’ experience with healthcare compliance, healthcare administration, auditing or healthcare regulatory affairs
• Strong knowledge of healthcare laws and regulations, including HIPAA Privacy and Security Rules, Medicare and Medicaid regulations, Medicare Advantage regulations, CMS Conditions of Participation, OIG Compliance Program Guidance, Stark Law, Anti-Kickback Statute, False Claims Act
• Experience working in healthcare quality, compliance, operations and supporting the risk assessment process, monitoring or audit activities and response to inquiries
• Experience conducting compliance audits and investigations (including breach responsiveness)
• Bilingual (English and Spanish) preferred
• Self-starter and interested in learning and developing expertise in new and emerging areas through education, networking and new experiences
• Critical thinking and problem-solving skills
• Effective communication and presentation skills; written and verbal
• Strong analytical, organizational, and problem-solving skills
• Ability to embrace and simplify complex concepts
• Strong attention to detail
• Excellent written and verbal communication skills
• Enjoy building and developing relationships
• Located in Texas or Arizona