Vynca

Compliance Specialist

Vynca

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $85,000 - $105,000 per year

About the role

  • Support the design, implementation, and ongoing maintenance of the organization’s healthcare compliance program in alignment with OIG and DOJ Compliance Program Guidance.
  • Assist in operationalizing the seven elements of an effective compliance program, including policies and procedures, training, monitoring, auditing, reporting, and enforcement.
  • Serve as a key resource to internal stakeholders on compliance-related questions and issues, providing guidance to translate regulatory requirements into actionable organizational practices.
  • Support compliance and quality oversight for Enhanced Care Management (ECM) and Palliative Care programs in alignment with federal, state, and payer requirements.
  • Monitor regulatory and contractual requirements while tracking evolving guidance impacting program operations, care delivery, and documentation standards.
  • Conduct audits, monitoring, and QAPI activities, including metric tracking, trend analysis, and support for corrective action plans.
  • Collaborate cross-functionally to address compliance risks, support audit readiness, and integrate quality and compliance standards into program workflows.
  • Monitor federal and state healthcare laws and regulations, including but not limited to Anti-Kickback Statute, Stark Law, False Claims Act, HIPAA, and applicable state healthcare regulations.
  • Track DOJ and OIG enforcement actions, advisory opinions, special fraud alerts, and compliance guidance, and assess applicability to organizational operations.
  • Conduct compliance risk assessments and help identify, document, and address compliance risks, including fraud, waste, and abuse (FWA), enforcement trends, government oversight, and internal audits.
  • Support regulatory change management by tracking new or updated laws, regulations, and enforcement trends, including monitoring requirements for potential new markets as the organization expands.
  • Assist with compliance audits, monitoring activities, and reviews to assess adherence to internal policies and regulatory requirements.
  • Support internal investigations related to potential compliance concerns, including documentation, issue tracking, and corrective action plans.
  • Coordinate responses to compliance inquiries, audits, and regulatory requests, as directed by Compliance Leadership.
  • Maintain investigation and audit documentation in accordance with DOJ and OIG standards and expectations.
  • Assist in developing and delivering compliance training and education programs for employees, contractors, and leadership.
  • Promote awareness of compliance reporting mechanisms and non-retaliation standards.
  • Draft compliance communications, guidance documents, and policy updates, and support implementation of compliance guidance into day-to-day operations.
  • Maintain organized, audit-ready records.
  • Collaborate with internal departments to streamline workflows and improve regulatory preparedness.
  • Stay informed on state and federal regulatory requirements.
  • Support ad-hoc compliance and quality initiatives, including policy updates, audits, and corrective action implementation, as needed.

Requirements

  • Bachelor’s degree in Healthcare Administration, Compliance, Legal Studies, Business, or a related field, or equivalent healthcare compliance experience.
  • 2+ years of experience in healthcare compliance, regulatory affairs, audit, or a related role.
  • Working knowledge of healthcare compliance laws and regulations at the federal and state level.
  • Familiarity with healthcare enforcement trends and OIG/DOJ Compliance Program Guidance and enforcement priorities.
  • Experience supporting quality assurance and performance improvement (QAPI) initiatives, audits, or quality monitoring activities.
  • Strong analytical, organizational, and documentation skills.
  • Strong understanding of healthcare compliance and regulatory frameworks.
  • Ability to analyze regulations and translate them into practical guidance.
  • High ethical standards and sound judgment.
  • Excellent written and verbal communication skills.
  • Detail-oriented with strong follow-through.
  • Ability to assess operational compliance gaps and make risk-based decisions.
  • Certification in Healthcare Compliance (CHC) or similar compliance certification (Preferred).
  • Experience supporting compliance audits, investigations, or regulatory examinations (Preferred).
  • Knowledge of CMS regulations and reimbursement compliance (Preferred).
  • Experience with Enhanced Care Management (ECM), Palliative Care programs, or similar care management models within Medicaid or managed care environments (Preferred).
Benefits
  • medical, dental, and vision insurance
  • income protection benefits
  • flexible PTO
  • company holidays
  • 401k
  • access to other wellness benefits
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
healthcare complianceregulatory affairsauditquality assuranceperformance improvementcompliance risk assessmentsmetric trackingtrend analysisdocumentation standardspolicy updates
Soft Skills
analytical skillsorganizational skillsdocumentation skillsethical standardsjudgmentwritten communicationverbal communicationdetail-orientedfollow-throughrisk-based decision making
Certifications
Bachelor’s degree in Healthcare AdministrationBachelor’s degree in ComplianceBachelor’s degree in Legal StudiesBachelor’s degree in BusinessCertification in Healthcare Compliance (CHC)