Product Manager, Risk Adjustment Coding Data Integration
Datavant
SDLC
Compliance Manager
InStride Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $135,000 - $155,000 per year
Job Level
Mid-LevelSenior
About the role
- 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
Requirements
- 5+ years of experience in healthcare compliance or regulatory work (Bachelor’s degree required; J.D. preferred)
- Strong working knowledge of key topics such as HIPAA, patient consent, licensing, privacy, contract compliance, and mandatory reporting
- Demonstrated ability to operate as a self-starter who can exercise sound judgment, make informed decisions, and drive projects forward
- Excellent analytical, organizational, investigative, and communication skills
- Experience working in a fast-paced, rapidly changing environment (ideally in a healthcare-tech start-up)
- Solutions-focused, progressive thinker with a passion for transforming pediatric mental health care
- Team-oriented, energetic, and ambitious, with a healthy balance of curiosity, humility, and assertiveness
