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WelbeHealth

Unlocking the full potential of our most vulnerable seniors.

Manager, Compliance – Program Integrity

Program ManagerProgram ManagerFull TimeRemoteSeniorTeam 501-1,000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

$109.2K - $144.2K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Manager, Compliance – Program Integrity

WelbeHealth

• Lead ongoing development, coordination, and oversight of the WelbeHealth FWA Prevention Program, including the prevention, detection, documentation, investigation, and resolution of potential FWA across WelbeHealth operations • Partner and coordinate with operational leadership to ensure alignment with all federal and state program integrity requirements, as well as industry best practices • Collaborate with Compliance leadership to establish, update, and maintain policies, procedures, and monitoring systems supporting FWA prevention and compliance • Provide subject-matter expertise and guidance to internal stakeholders on regulatory compliance matters related to FWA prevention and operations • Develop and deliver FWA prevention training programs for team members at all levels • Develop and maintain relationships with external entities, including CMS, law enforcement, vendors, and partner agencies, related to investigations and reporting requirements • Collaborate with internal auditors, legal counsel, and operational teams to support internal and external audits and investigations, ensuring timely and accurate responses, as well as track, analyze, and report on program integrity metrics, trends, and outcomes to the Senior Director, Corporate Compliance and oversight bodies as appropriate

Job Requirements

  • Bachelor’s degree in healthcare administration, business administration, law, compliance, or a related field required
  • Advanced degree or professional certification such as Certified in Healthcare Compliance (CHC), Certified Fraud Examiner (CFE), or Certified in Healthcare Privacy and Compliance (CHPC) preferred
  • Minimum of five (5) years of experience in a relevant field such as healthcare compliance, program integrity, FWA prevention, or fraud investigation oversight within a managed care or Medicare environment
  • In-depth knowledge of federal and state Medicare and Medicaid FWA regulations and healthcare compliance frameworks
  • Experience leading or conducting complex investigations including data analysis, documentation, and reporting
  • Strong ability to build effective cross-functional relationships with operational and leadership stakeholders.

Benefits

  • Medical insurance coverage (Medical, Dental, Vision)
  • Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
  • 401K savings + match
  • Comprehensive compensation package including base pay and bonus
  • And additional benefits!

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