Bachelor's degree in healthcare administration, nursing, health information management, business, compliance, or related field; equivalent experience considered.
3-5 years of experience in healthcare compliance, regulatory compliance, auditing, or investigations.
Experience managing a compliance hotline, including intake and resolution processes.
Demonstrated experience conducting and documenting internal investigations.
Preferred: Experience in skilled nursing or multi-facility healthcare organizations.
Preferred: Certified in Healthcare Compliance (CHC) or relevant certification.
Preferred: Clinical background such as Registered Nurse (RN).
Responsibilities
Assist in developing and maintaining the Corporate Compliance Program according to laws and regulations.
Monitor compliance with CMS requirements and state regulations across facilities.
Support compliance committees through meeting preparation and reporting.
Manage the compliance hotline and promote reporting channels.
Conduct investigations of alleged compliance violations and prepare detailed reports.
Coordinate annual compliance risk assessments and identify emerging risks.
Assist in developing risk-based audit plans and evaluate operational practices.
Benefits
401(k) with company match
Blue Cross Blue Shield Medical Insurance
Dental, Vision, and Disability insurance
Employee Assistance Program (EAP)
Access to Employee Discount Program
Generous Paid Time Off
Opportunities for Growth and Advancement
Innovative Training Program
Full Job Description
The Compliance Manager supports the Chief Compliance Officer in developing, implementing, and maintaining the Corporate Compliance Program across corporate departments and all skilled nursing facilities. The role manages the compliance hotline, conducts investigations, performs risk-based audits and monitoring, and drives corrective action and compliance education, ensuring adherence to CMS requirements, OIG guidance, and applicable federal and state laws.
This role is a full-time role based out of Lincolnwood, IL office Monday-Friday on-site. Ideal candidates must be open to travelling to Illinois, Michigan, and Ohio care centers, if needed.
Compliance Manager Duties and Responsibilities:
Compliance Program Oversight
Assist in developing, implementing, and maintaining the Corporate Compliance Program in accordance with federal and state laws, regulations, and guidance.
Monitor compliance with CMS requirements, OIG guidance, and state regulatory requirements across all facilities.
Support the Corporate Compliance Committee and facility compliance and QAPI committees through meeting preparation, reporting, and follow-up.
Monitor completion of required compliance training and employee attestations; support compliance education, Compliance Ambassadors, and initiatives that promote a culture of ethical conduct.
Support Corporate Integrity Agreement (CIA) requirements, if applicable, including audits, certifications, reporting, and documentation.
Hotline Management and Complaint Intake
Manage and promote the compliance hotline and other reporting channels, including anonymous and confidential reports, reinforcing non - retaliatoin and good-faith reporting.
Receive, document, categorize, and assess allegations of compliance violations, misconduct, fraud, waste, abuse, neglect, and retaliation; determine response priority and escalation needs.
Maintain confidential hotline logs and case files, and monitor open cases to ensure timely investigation, follow-up, documented resolution, and escalation as needed.
Identify hotline trends and facility-specific patterns to guide training and corrective action.
Compliance Investigations
Conduct and coordinate investigations of alleged violations, misconduct, fraud, waste, abuse, conflicts of interest, and retaliation, including developing plans, interviewing witnesses, and reviewing records.
Prepare objective, well-documented investigation reports with timelines, findings, conclusions, and recommended actions; maintain confidential investigation files.
Recommend and monitor corrective and preventive actions based on root causes, confirming they are implemented and effective.
Risk Assessment and Mitigation
Coordinate the annual compliance risk assessment and help facilities identify, evaluate, and prioritize risks.
Review regulatory updates, enforcement trends, audit results, and hotline data to identify emerging risks, and recommend revisions to the compliance work plan and audit schedule.
Auditing and Monitoring
Assist in developing and implementing risk-based audit and monitoring plans across corporate departments and skilled nursing facilities.
Audit operational practices, clinical documentation, billing, reimbursement, and personnel records through observations, record reviews, interviews, and data analysis.
Evaluate internal controls and prepare audit reports with findings, evidence, risk levels, recommendations, and required corrective actions for leadership.
Maintain audit workpapers and evidence, and use trend data to support ongoing program evaluation and improvement.
All other duties as assigned.
Compliance Manager Skills and Abilities:
Working knowledge of CMS regulations, OIG compliance guidance, Medicare and Medicaid requirements, and state nursing facility regulations.
Knowledge of HIPAA privacy and security, resident rights, abuse and neglect reporting, and fraud, waste, and abuse prevention.
Strong analytical, organizational, investigative, and problem-solving skills.
Excellent written and verbal communication, including preparing formal investigation reports and presenting findings to leadership.
Ability to handle sensitive information with discretion, maintain confidentiality, and exercise sound judgment.
Proficiency with Microsoft Office, Excel, reporting dashboards, and electronic tracking systems.
Preferred experience with root cause analysis, QAPI, corrective action effectiveness reviews, electronic health records, and compliance tracking systems.
Compliance Manager Education and Experience:
Required
Bachelor's degree in healthcare administration, nursing, health information management, business, compliance, or a related field; equivalent relevant experience may be considered.
Minimum of 3-5 years of experience in healthcare compliance, regulatory compliance, auditing, investigations, or a related healthcare role.
Demonstrated experience managing a compliance hotline, including intake, documentation, triage, tracking, and resolution.
Demonstrated experience conducting and documenting internal investigations.
Preferred
Experience in skilled nursing, long-term care, post-acute care, or a multi-facility healthcare organization (strongly preferred).
Certified in Healthcare Compliance (CHC) or another relevant compliance certification.
Registered Nurse (RN) or other clinical background.
Experience presenting audit results, risk assessments, and compliance trends to executive leadership or board-level committees.
Experience supporting regulatory surveys, external audits, and government investigations.
Physical Requirements:
Ability to travel to skilled nursing facilities.
Walking, reaching, bending, lifting, extended sitting, grasping, fine hand coordination, pushing and pulling, ability to distinguish smells and temperatures, all with or without the aid of mechanical devices is required.
Limited potential for exposure to environmental hazards. Understanding and adherence to company safety standards and protocols required.
Meet all health requirements as needed.
Dialogue concerning ADA reasonable accommodations are always available upon request - i.e. the interactive process.
Omnia Healthcare Group Full-Time Benefits:
Competitive Compensation
401(k) with company match
Blue Cross Blue Shield Medical Insurance.
Dental, Vision, and Disability insurance
Employee Assistance Program (EAP)
Access to Employee Discount Program
Generous Paid Time Off
Opportunities for Growth and Advancement
Innovative Training Program
And much more!
Apply to join a Growing Team Today!
Apply today and take the next step toward a career where your work supports the people behind care and helps make people better across the Omnia Network. We look forward to receiving your application.
