Health Care Service Corporation

Manager Compliance Investigations

Health Care Service Corporation$92K — $167K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in a relevant field and 5 years of investigative compliance experience or 9 years of equivalent experience.
  • 1 year of management or leadership experience.
  • Knowledge of Ethics & Compliance Hotline Operations and reporting.
  • Familiarity with external governmental agencies like EEOC and CMS.
  • Experience with compliance program elements and policy documentation.
  • Strong analytical and decision-making skills.
  • Excellent verbal and written communication skills.

Responsibilities

  • Oversee the Corporate Integrity Hotline operations and ensure compliance with guidelines.
  • Investigate and resolve hotline inquiries related to misconduct.
  • Analyze reported allegations and prepare reports for senior leadership.
  • Implement metrics to assess hotline effectiveness and compliance.
  • Maintain strict confidentiality while managing high-priority projects.
  • Facilitate communication and documentation of hotline issues.
  • Support and mentor team members in achieving compliance objectives.

Benefits

  • Health and wellness benefits including medical and dental.
  • 401(k) savings plan with employer match.
  • Pension plan and disability insurance.
  • Paid time off, parental leave, and holidays.
  • Tuition reimbursement for professional development.
  • Employee assistance program for personal support.
Full Job Description
Job Summary

Responsible for the effective operation of the Corporate Integrity Hotline and related responsibilities in accordance with HCSC's Compliance Charter, Compliance Program, and U.S. Department of Justice Guidelines. Ensures timely and detailed investigation/resolution of hotline inquiries/allegations of misconduct and violations of the law. Responsible for the analysis of all reported allegations and the subsequent preparation of detailed reports for senior leadership.

Required Job Qualifications:
  • Bachelor's degree in Criminal Justice, Legal Studies, Risk Management, Business, Human Resources, or related field and 5 years of investigative experience in a compliance environment or its equivalent involving researching and investigating inquiries OR 9 years of investigative experience in a compliance environment or its equivalent involving researching and investigating inquiries.
  • 1 year of management/leadership experience.
  • Knowledge of and/or experience in Ethics & Compliance Hotline Operations, metrics, analysis and reporting.
  • Familiarity with external governmental agencies (i.e., EEOC, Department of Human Rights, CMS, OIG, etc.).
  • Knowledge of and/or experience with the 7 elements of a compliance program.
  • Knowledge of and/or experience in policy and procedure documentation.
  • Organizational decision-making and analytical skills.
  • Strong interpersonal skills.
  • Listening skills and ability to accurately document information reported.
  • Ability to influence processes to achieve results.
  • Ability to work independently, with guidance in only the most complex situations.
  • Support of high priority projects with highest level of confidentiality.
  • Effective verbal and written communication skills (Clear and concise verbal & written communication skills).


Preferred Job Qualifications:
  • Prior Law Enforcement or Military experience.
  • Juris Doctorate.
  • Certified Fraud Examiner (CFE) designation.
  • Certified Compliance & Ethics Professional (CCEP) designation.
  • Certified in Healthcare Compliance (CHC) designation.
  • Proven success managing employees, fostering team development, and achieving business objectives through effective leadership.


This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Sponsorship is not available.

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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Base Pay Range
$92,700.00 - $167,500.00

Exact compensation may vary based on skills, experience, and location.

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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