Job Description

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

• We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
• We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
• We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
• We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.

Job Summary:

As a member of the Regulatory Compliance team, the Compliance Manager will primarily focus on leading compliance investigations to ensure adherence to regulatory standards across all SCA Health (SCAH) affiliated facilities. The Compliance Manager will also assist in the day-to-day support of the operations of the Regulatory Compliance Department. The Compliance Manager will work closely with the Compliance Operations team to ensure the compliance program is carried out to all SCAH facilities.

Key Responsibilities:

• Lead compliance-related investigations to identify, analyze, and resolve issues of non-compliance, including suspected fraud, abuse, or misconduct.
• Collaborate with relevant departments and stakeholders to develop and implement corrective action plans based on investigation outcomes.
• Assist with management of Regulatory Compliance Leads program
• Manage the compliance diligence, integration, and acquisition processes
• Manage compliance support functions performed by the Compliance Operations team (exclusion screenings, hotline, joint venture slides, etc.)
• Working effectively with other departments/external sources
• Working as part of a team who support each other to accomplish set goals and objectives together

• Qualifications:

• • Strong understanding of healthcare compliance and compliance related principles
  • Strong understanding of regulatory compliance processes and internal controls
  • Strong critical thinking, organizational skills and an orientation to deadlines and detail
  • Demonstrate independence in solving complex issues
  • Proven ability to conduct thorough investigations, manage sensitive matters, and develop appropriate corrective action plans.
  • Clear, concise and persuasive writing and communication skills, particularly in reporting investigative findings and presenting recommendations.
  • Ability to draft and revise documents including policies and standards
  • Flexible attitude and open to changes in the day-to-day work schedule
  • Strong skills in use of information systems, databases, Excel, and Microsoft Word
  • Excellent teamwork and interpersonal skills
  • Strong mission and values commitment; natural cultural fit

  Education and Work Experience:

  • Bachelor’s Degree required.
  • 5+ years’ experience in health care compliance, audit, quality assurance, or other similar field.
  • Demonstrated experience in conducting compliance investigations, with a proven track record of managing complex compliance issues.

  Certifications:

  If not already achieved, obtain either of the below certifications within first two years of employment:

  • Certification in healthcare compliance (CHC)

  Other considerations (not requirements):

  • Certified Fraud Examiner (CFE) credential
  • Project management experience
  • Coding experience
  • Audit experience

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