Manager, Compliance

More information about this job JOB OVERVIEW

"Sunrise is the best place that I've ever worked, simply because of the people. We provide quality care in an environment that feels like home. Our focus is doing what’s right for the resident. For me, that’s a big breath of fresh air."

- Sunrise Leader

Sunrise Senior Living has an immediate need for an experienced healthcare compliance professional at its corporate office in McLean, VA (Tysons Corner).

The Manager, Compliance reports to the Vice President, Internal Audit and Compliance and assists with the day-to-day management of the company’s Compliance Program that is tasked with preventing illegal, unethical and improper conduct. More specifically, the selected candidate will: conduct compliance audits, including audits of Medicare, Managed Care, and Medicaid claims and billing, Minimum Data Sets (MDS), and clinical documentation at skilled nursing and assisted living communities; and maintain and ensure the effectiveness of the Sunrise’s Compliance Program, serving as a corporate resource for Medicare, Managed Care, and Medicaid reimbursement information, and maintaining compliance with applicable federal and state rules and regulations, including applicable healthcare laws.

RESPONSIBILITIES & QUALIFICATIONS

Responsibilities

• Developing, initiating, maintaining and revising policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical or improper conduct
• Developing and enhancing compliance training for employees; providing education and training about actual, proposed, or pending compliance-related legislation and regulations that affect the organization
• Developing audit programs and performing ongoing compliance audits, including audits of Medicare, Managed Care, and Medicaid claims and billing, MDS, and clinical documentation
• Preparing audit reports; outlining audit results, trends, and recommendations for improving business processes and validating effective implementation of corrective action plans
• Investigating alleged compliance issues and violations of rules, regulations, policies, procedures, and standards of conduct
• Identifying potential areas of compliance vulnerability and risk, developing and implementing corrective action plans for resolution of problematic issues, and providing general guidance on how to avoid or deal with similar situations in the future
• Monitoring the performance of the compliance program and related activities on a continuing basis, and taking appropriate steps to improve its effectiveness

Qualifications

• Registered Nurse with active license (preferred) or a master’s degree in healthcare administration
• A minimum of five (5) years of experience in a skilled nursing setting or other clinical environment, including experience MDS, ICD-10 coding, Medicare, Managed Care, and Medicaid claims and billing
• A minimum of two (2) years of experience in compliance audits, including audits of Medicare, Managed Care, and Medicaid coding and billing, MDS, and clinical documentation
• Familiarity with Medicare, Managed Care, Medicaid, and healthcare laws, regulations and standards
• Ability to travel required (up to 70%)
• Strong analytical and problem-solving skills directly related to Medicare, Managed Care, and Medicaid coding and billing auditing to ensure compliance with regulatory guidance
• Ability to adhere to firm deadlines and have the aptitude to interpret and apply regulations
• Must be organized, detail oriented, able to exercise strong independent judgment; possess conflict resolution and persuasion skills
• Must be a team player with excellent communication and presentation skills; must be able to work effectively with various internal departments/levels of management
• Must be proficient Microsoft Office applications, e.g., Word, Excel, PowerPoint, etc.
• Knowledge of electronic health record (PointClickCare) software preferred
  

*LI-DV1

Sunrise maintains a drug-free work environment and all offers of employment with Sunrise are conditioned on submitting to and successfully completing and passing a drug and alcohol test.
ABOUT SUNRISE

Sunrise Senior Living has championed quality of life in senior care for more than 30 years. We believe team members are our greatest resource and are looking for people who share our commitment to provide quality care for seniors and their families. It's no surprise that many of the world's leading experts in Senior Living entrust their career to Sunrise.

At Sunrise, you will…

Make a Difference Every Day
We are passionate about our mission — to champion quality of life for all seniors. We deliver high-quality care with a personal touch and encourage our residents to enjoy life to the fullest.

Be Part of a Uniquely Supportive Community
The care-focused environment we create for residents extends to our team members. We offer programs, rewards, and benefits to help you live your best.

Ignite Your Potential
We believe potential has no limits. We offer best-in-class leadership development programs designed to grow our leaders. We are committed to helping our team members achieve their career goals.