Senior Compliance Manager

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

📋 Description

• Assist in implementing Teladoc Health’s daily Compliance Program in collaboration with senior leadership.

• Work together with Legal and cross-functional teams for the effective execution of the compliance program.

• Act as a subject matter expert in specified compliance areas.

• Create, revise, implement, and supervise compliance policies and procedures.

• Ensure compliance with internal controls and organizational standards.

• Monitor changes in regulations, relevant laws, standards, and best practices regarding compliance.

• Provide advice on regulatory issues related to accessibility.

• Support RCM compliance training concerning coding, billing, claims, denials, and revenue integrity.

• Oversee internal compliance audit controls focused on RCM, billing, and coding.

• Identify opportunities for enhanced monitoring and investigation.

• Track compliance activities, trends, outcomes, and areas for improvement.

• Conduct internal audits and enforce corrective actions.

• Contribute to the annual audit and compliance work plan and report findings.

• Manage the RCM, billing, and claims compliance framework along with the annual plan.

• Provide dashboards and executive summaries on RCM compliance status, issues, trends, corrective measures, and key risk indicators.

• Investigate compliance issues and allegations related to RCM, billing, and coding.

• Collect and analyze data to identify root causes.

• Collaborate with Legal, HR, and other departments during investigations.

• Assist in investigations related to regulatory inquiries such as CMS and OIG.

• Appropriately escalate issues, implement corrective actions, resolve compliance challenges, and monitor results.

• Lead the annual RCM compliance risk assessment across various business lines, modalities, specialties, and payer segments.

• Design and maintain preventive and detective controls within the revenue cycle.

• Perform risk assessments and gap analyses.

• Monitor federal and state regulatory changes and inform leadership of their impacts.

• Develop and support processes that address evolving regulatory mandates.

• Keep compliance-related documentation and resources up to date.

• Collaborate with Legal and business functions on investigations and compliance initiatives.

• Aid in regulatory responses and compliance-related tasks.

• Analyze compliance data to identify potential risks and trends.

• Enhance monitoring, investigative, and compliance processes.

• Support the Chief Compliance Officer in executing the Enterprise Compliance Program.

• Perform additional compliance-related responsibilities as required.

⛳️ Requirements

• Bachelor’s degree in a relevant field is preferred.

• 8-10 years of experience in compliance, risk management, audit, or a similar function.

• Experience in regulated industries such as healthcare, financial services, insurance, or comparable sectors is preferred.

• Certified Compliance & Ethics Professional (CCEP), Certified Healthcare Compliance (CHC), or an equivalent certification is preferred.

• Other relevant certifications in risk, audit, or quality such as CPHQ, CIA, or CISA are preferred.

• Strong understanding of compliance frameworks, regulatory mandates, and internal control principles.

• Experience with audits, investigations, and risk assessments.

• Ability to interpret regulations and translate them into actionable business practices.

• Excellent communication and interpersonal skills, with the ability to influence stakeholders.

• Capability to manage multiple priorities in a dynamic environment.

• High degree of attention to detail, organizational skills, and accountability.

• Proficiency in standard business and reporting software, such as Microsoft Office or its equivalent.

• Must be authorized to work in the United States without current or future visa sponsorship.

• Must successfully complete identity and credential verification, interviews, and screening for fraud or misrepresentation.

🏝️ Benefits

• Performance bonus.

• Flexible Vacation Policy.

• 80 hours of Paid Sick, Safe, and Caregiver Leave per year.

• Employee-centered benefits program for employees and their families.

• Significant career growth opportunities.

• Inclusive workplace culture.

• Resources for candidates and support from recruiters.