Compliance and Privacy Manager - JD

Responsibilities

The Compliance and Privacy Manager will oversee compliance risk areas including general program effectiveness, fraud and abuse, patient privacy, and federal healthcare program compliance. The Manager will:

• Support the Director of Corporate Compliance with policy implementation, training, and investigations.
• Perform reviews based on U.S. Department of Health and Human Services guidance, CMS conditions, and Medicare compliance regulations.
• Maintain reporting systems, coordinate internal audits, and monitor HIPAA and patient privacy compliance.
• Ensure the program promotes prevention, detection, and resolution of improper conduct in alignment with state and federal laws, hospital policies, and IT security standards.
• Investigate non‑compliance incidents, prepare findings reports, and follow up on investigative results.
• Assess organizational policies, update, or develop new policies.
• Evaluate billing, Stark, anti‑kickback, and patient privacy risk areas; collaborate with managers to eliminate potential risks.
• Manage and investigate compliance questions, complaints, and reported incidents in collaboration with legal, HR, and management.
• Perform data analytics to monitor and audit compliance; manage case management and federal reporting.
• Develop an organization‑wide compliance communication plan, training programs, and coordinate HIPAA security compliance activities with the HIPAA Security Officer.
• Draft responses to HIPAA regulatory inquiries and review business associate agreements, data use agreements, and limited data set agreements for compliance.
• Conduct risk assessments, audits, and training; prepare PowerPoint presentations; draft policies and procedures related to compliance and privacy.
• Assist in conflict‑of‑interest reviews and determinations.

Education

* Juris Doctor from an ABA‑accredited law school; admission to the bar in one of the 50 states or Washington, D.C.
* Master’s Degree in public health, healthcare, accounting, allied health, or related field is a plus.

Certifications

* CCEP or CHC designation preferred; CHC required within 12 months of appointment.
* CISA, CRISC, or AAIA designation required within 18 months of employment.

Experience

* Five years minimum of health care compliance experience; health care administration, legal, fraud, waste, and abuse, internal audit, regulatory affairs.
* Minimum five years of compliance investigations experience required.
* Managerial experience in a healthcare organization preferred.

Technical Skills

* Proficiency in Microsoft Word, Excel, and PowerPoint.

Other Required Skills

* Current knowledge of business ethics, legal and compliance risks.
* Advanced communication and influencing skills.
* Excellent writing skills.

Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.