Compliance Manager

This is a fully remote position, open to applicants in Texas.

📋 Description

• Develop, implement, and continuously enhance Dozee's healthcare compliance program encompassing Medicare RPM billing, HIPAA privacy and security, FDA device compliance, and adherence to the Anti-Kickback Statute.

• Report directly to the VP of Administration and act as the primary compliance operator on a daily basis.

• Oversee monthly compliance reviews for Medicare RPM billing, including the selection of CPT codes, data-day thresholds, mutual exclusivity rules, dual attestation, and enforcement of the 99458 MUE cap.

• Keep track of CMS Final Rules, MAC Local Coverage Determinations, and items from the OIG Work Plan; provide leadership with briefings on significant updates.

• Act as the designated HIPAA Compliance Officer; perform annual Security Risk Assessments, manage the Notice of Privacy Practices, and supervise the lifecycle of Business Associate Agreements (BAAs).

• Lead investigations into breaches and manage notification workflows.

• Maintain the CAIT/Dozee Standard Operating Procedure (SOP) library, including the annual review cycle, version history, and change logs.

• Conduct monthly random-sample audits of at least 10% of submitted claims; monitor findings and implement corrective actions.

• Design, implement, and track annual compliance training as well as staff attestations.

• Keep track of overpayments and ensure that refunds are processed within the 60-day statutory timeframe.

• Monitor changes to state NP practice acts in all operating states and track compliance obligations related to grants.

• Review agreements with SNF partners and vendors to ensure compliance with the Anti-Kickback Statute; maintain contract files and review schedules.

⛳️ Requirements

• At least 5 years of experience in healthcare compliance.

• Certification in Healthcare Compliance (CHC) is required or must be obtained within 12 months of hire.

• CHPC (privacy) certification is an advantage.

• Solid understanding of CPT coding (99453–99470), CMS PFS Final Rules, OIG Work Plan, MAC audit processes, and AKS/Stark safe harbors.

• Excellent skills in SOP writing, audit documentation, and cross-functional communication.

• Ability to conduct training sessions for both clinical and non-clinical staff.

• Familiarity with healthcare compliance platforms is preferred.

• Proficiency in Microsoft 365 is mandatory.

• A Bachelor's degree is required; preference for fields related to healthcare administration, law, or clinical studies.

🏝️ Benefits

• Equal opportunity employer.

• Inclusive work environment.

• Commitment to diversity.