Compliance Manager

Company Description

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Job Description

Reporting to the Director, Compliance & PMG Compliance Officer, the Compliance Manager will ensure all required elements of an effective Compliance Program are met. This position will be responsible for assisting with execution of our compliance plan and the organization’s compliance education program. The Manager, Compliance will assist in review and development of processes and controls to ensure compliance with state and federal laws and regulations applicable to Privia Health. 

 Primary Job Duties: 

• Serve as a Subject Matter Expert in health care compliance and maintain a current knowledge of healthcare legal and regulatory requirements and industry standards

• Research Federal and State regulations and payor contract requirements on assigned compliance topics

• Partners and collaborates with the Compliance Department, senior leadership, and legal counsel to develop guidance on all new and current business initiatives

• Assist in the implementation of Privia’s Compliance Program in new  markets

• Assist in responding to regulatory and payor audit requests

• Assist in the management of the day-to-day compliance program 

• Assists in the development, modification, communication, and implementation of policies and procedures

• Assist Director, Compliance with managing and maintaining organization’s policy and procedure tool

• Assists in the development and execution of annual compliance and monitoring plans, including performing the risk assessment and implementing corrective action plans where needed

• Coordinate with the Coding Compliance and Integrity Team to ensure appropriate action plans are in place and monitored

• Work with Compliance, Legal, IT Security and Training teams to maintain compliance education and training materials

• Perform internal compliance audits and investigations as assigned, including risk-based audit program development, testing and drafting results

• Collaborate with departmental management to develop formal corrective actions to ensure compliance

• Support the Director, Compliance in preparation and delivery of reports to various stakeholders and Executive Management team

• Perform tasks assigned by the Market Compliance Committees

• Participate in Compliance Committee meetings and assist in the preparation of related materials.

• Assists the Director, Compliance with compliance special projects

• Experience with ACO’s is beneficial

• Perform other duties as assigned

Qualifications

• Bachelor’s Degree preferred or relevant equivalent experience

• 5+ years’ experience in healthcare compliance with a keen understanding of compliance risks

• Knowledge of laws regulations impacting healthcare; Able to review and understand regulations and guidelines and apply them to business practices

• Compliance Certification (CHC, CHPC, CHRC, or CHC-F) preferred 

• Must comply with HIPAA rules and regulations

The salary range for this role is $95,000 to $115,000 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 15% & restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Additional Information

All of your information will be kept confidential according to EEO guidelines.

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.