Compliance Manager

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

📋 Description

• Oversee daily compliance with Medicare and Medicaid program standards, which include federal CMS regulations, state-specific Medicaid laws, and obligations related to value-based care contracts.

• Track regulatory changes and convey their implications into straightforward, actionable advice for product, clinical, and operations teams.

• Lead the organization’s responses to audits, compliance evaluations, and inquiries from federal and state regulators, health plans, and contract partners.

• Develop and continuously enhance the compliance program framework, which encompasses policies, procedures, risk assessments, and training initiatives.

• Serve as the primary authority on HIPAA Privacy and Security compliance, including BAA management, adherence to minimum necessary standards, and workforce training.

• Collaborate with engineering and product teams to assess data practices, new product features, and vendor integrations for privacy and security risks.

• Advance the organization’s privacy and data security efforts in collaboration with cross-functional teams.

• Function as a trusted advisor to business, product, and clinical teams—identifying compliance risks early and assisting in the design of compliant solutions rather than hindering progress.

• Establish and maintain a compliance risk register; assess issues based on severity and likelihood, prioritizing remediation relative to actual risk.

• Develop scalable, efficient compliance processes that align with a dynamic environment and minimize unnecessary organizational drag.

• Collaborate closely with the legal team on regulatory strategies and the escalation of high-stakes issues.

• Work with clinical operations on compliance related to care delivery, including documentation standards, authorization requirements, and billing compliance.

• Partner with the People team on compliance training, onboarding, and workforce policy development.

• Represent Pair Team in a professional and compliant manner during discussions with partners, health plans, and regulatory bodies.

⛳️ Requirements

• Minimum of 3 years of experience in healthcare compliance with direct exposure to federal programs (Medicare, Medicaid, or both) and the regulatory frameworks that govern these programs (CMS, OIG, HIPAA, FWA).

• Proven ability to thrive in an ambiguous, fast-paced environment—experience in a startup or high-growth company is highly preferred.

• Extensive knowledge of HIPAA Privacy and Security regulations and their practical application to technology products and digital health services.

• Experience in building or significantly enhancing compliance programs, rather than merely operating within existing ones.

• Excellent communication skills—capable of articulating complex regulatory requirements in simple terms and making clear risk/benefit recommendations to business leaders.

• Ability to manage multiple tasks, prioritize effectively, and oversee projects and tasks efficiently.

• Experience in developing processes, procedures, and workflows that facilitate sustainable business growth.

• Strong collaboration skills with colleagues from clinical, operations, finance, and leadership sectors.

• Demonstrated ability to prioritize competing demands and make decisions proportionate to risk.

• Passionate about enhancing outcomes for underserved communities and mission-driven.

• Strongly Preferred: Experience within a digital health company, health plan, or managed care organization involved in Medicaid and/or Medicare programs.

• Familiarity with value-based care contracts, capitation models, or risk-bearing entities and their compliance ramifications.

• CHC, CHPC, or other relevant compliance certifications are a plus.

🏝️ Benefits

• Competitive salary: $100,000- $115,000

• Equity compensation package

• Flexible vacation policy – take the time you need to recharge

• Comprehensive medical, dental, and vision coverage

• 401(k)

• 100% company-sponsored short and long-term disability and life insurance

• Subsidized backup childcare and caregiver supports through Wellthy

• Work entirely from the comfort of your own home

• Monthly $100 work from home expense stipend

• We provide the equipment needed for the role

• Opportunity for rapid career progression with plenty of room for personal growth!