Compliance Project Manager

Reporting to the Senior Director of the Project Management Office, you will assist with the delivery and management of projects to support compliance with legal and internal regulations. Your role will serve as a skilled organizer with the opportunity to help develop the Compliance organization and its associated processes. You will provide guidance and strategic direction on compliance-related matters across the organization.

Job Description:

Ensure compliance with federal and state healthcare regulations, such as HIPAA, Medicare Part D, and ACA requirements.

Develop and implement compliance programs to monitor adherence to healthcare-related contracts and formularies.

Conduct audits and risk assessments to identify potential compliance issues within operational processes.

Collaborate with cross-functional teams, including legal, clinical, and operational departments, to address compliance concerns.

Manage projects related to regulatory changes, ensuring timely implementation and communication across the organization.

Provide training to employees on healthcare compliance policies and procedures.

Prepare detailed reports for senior management and regulatory bodies, highlighting compliance metrics and improvement plans.

Preferred Qualifications:

Bachelor’s degree; advanced degrees or certifications (e.g., PMP, CCEP) are a plus.

Strong understanding of healthcare regulations and standards.

Proven experience in project management, with the ability to handle multiple compliance-related projects simultaneously.

Excellent analytical, communication, organizational, and problem-solving skills.

In-depth knowledge of healthcare operations, including formulary management, claims processing, and provider networks

Experience with healthcare operations and regulatory issues

Strong understanding of federal and state healthcare laws and regulations