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Healthfirst Manager, Compliance Programs in New York, New York


The Compliance Program Manager’s role is critical to maintaining transparency in the Compliance Program and fostering a culture of compliance throughout the organization. The Compliance Program Manager supports the Compliance Director and works closely with team members throughout the organization to identify compliance issues, facilitate productive problem|solving discussions, and effectively mitigate compliance risks.

Active participation, input and support in the daily functional requirements of the Compliance Program, including but not limited to the following essential responsibilities:

  • Assists in Corporate Compliance Committee activity and assessing overall compliance program effectiveness

  • Works closely with compliance committees/compliance liaisons to develop, implement and manage compliance activities

  • Attends and participates in the Audit Compliance Meeting, Risk Adjustment Committee meeting and other compliance conferences/meetings as required

  • Works with external stakeholders to ensure compliance with Federal and State contract changes and model of care standards or other regulatory standards

  • Actively participates in identification of potential risk areas and facilitates development and implementation of corrective actions to ensure continued compliance

  • Ensures appropriate oversight of confidential compliance hotline and escalated issues

  • Supports the development, assessment, measurement and reporting of ongoing compliance initiatives

  • Coordinates the incident reporting and management process; monitors and documents progress and outcomes; escalates areas of non-compliance to management as required

  • Periodic review and revision of compliance policies and training materials; actively assist with educational development and training related to Compliance Program

  • Provide support for corporate compliance functions specific to organizational vulnerability/risk assessment and gaps

  • Maintains an in-depth understanding of organizational Code of Conduct, policies and procedures, as well as relevant federal and state laws, regulations, and health industry best practices

  • Assists with compliance auditing and monitoring activities

  • Effectively communicates with teammates and key partners

  • Monitors the performance of the compliance program and related activities on a continuing basis, taking appropriate steps to improve its effectiveness

  • Conducts other related activities and duties as assigned, including support core compliance program elements

Minimum Qualifications:

  • Associate's Degree Strong Medicare/Managed Care knowledgeThree years Corporate Compliance or Regulatory experience

  • Ability to work independently, in a fast-paced/changing environment. Ability to manage multiple projects/priorities simultaneously.

  • Excellent communication (verbal, written), presentation and organization skills essential. Must be able to deal effectively with multiple levels of management in different organizations.

  • Intermediate Microsoft Excel skills, and basic Microsoft Outlook, Word and PowerPoint skills, required.

Preferred Qualifications:

  • Experience with auditing tools and concepts.

  • Bachelor's degree

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

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