InStride Health

Compliance

• Serve as a primary point of contact for clinicians and business teams on compliance questions, especially regarding topics like HIPAA, patient privacy, consent, licensing, and care delivery.
• Partner with the Chief Compliance Officer to design and improve operational processes that support compliance (e.g., streamlining forms, clarifying workflows)
• Draft, maintain, and update policies and procedures that help staff understand and meet regulatory requirements.
• Develop and deliver compliance education for staff, including onboarding training, annual education, and topic-specific refreshers.
• Support delegated credentialing activities, including ensuring compliance with health plan credentialing requirements and responding to payor audits.
• Contribute to payor contract compliance oversight and participate in payor audits as needed.
• Support the continued development of the Quality Program, including monitoring quality metrics, assisting with audits, and participating in quality committees.
• Collaborate with other departments to direct compliance issues to the appropriate channels for investigation and resolution.
• Identify and escalate potential areas of compliance vulnerability and risk, and help develop corrective action plans to address them.
• Support compliant expansion into new markets by partnering with legal and clinical leadership and providing education on new regulatory requirements

Compliance Manager