Option Care
Manager, Compliance Investigations - Remote
Option Care, Itasca, Illinois, United States, 60143
Manager, Compliance Investigations - Remote page is loaded## Manager, Compliance Investigations - Remotelocations:
Itasca, ILtime type:
Full timeposted on:
Posted Todayjob requisition id:
R34040**Extraordinary Careers. Endless Possibilities.****With the nation’s largest home infusion provider, there is no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.**Job Description Summary:**The Manager, Compliance Operations & Investigations supports Option Care Health’s compliance investigation
program by managing investigations from intake through resolution, including allegations received through
established reporting channels. The role conducts root cause analyses, helps implement and track corrective
actions, identifies trends and systemic issues, and provides guidance and reporting to stakeholders. The
Manager collaborates with cross-functional partners to route matters appropriately, resolve issues efficiently,
mitigate compliance risk, and supports the maintenance of investigation, corrective action, and related
compliance polies and procedures in alignment with applicable laws and regulations.**Job Description:** Conduct investigations into fraud, waste, abuse, and other compliance concerns, ensuring thorough, objectiveanalysis and documentation.Support management of the company’s confidential Ethics & Compliance Hotline including intake, casemanagement workflow, reporting, analytics, and vendor relationships.Maintain accurate case records in the Compliance case management system.Develop, implement, and maintain investigation strategies, policies and processes to identify and addresspotential violations of laws, regulations, and internal policies.Collaborate with cross-functional partners to assess, triage, and route investigative matters for appropriateresolution and risk mitigation. Consult with Legal on compliance-related legal issues and timely communicaterelevant statutory, regulatory or policy changes to business unit leadership.Conduct root cause analysis and implement corrective actions. Monitor and track remediation completion.Prepare and present investigation reports to leadership and regulatory authorities, as necessary.Provide guidance on compliance policies, procedures, and best practices and foster a culture of ethical conduct and non-retaliation.Maintain current knowledge of relevant healthcare laws and regulations (e.g., HIPAA, Stark Law, Anti-KickbackStatute, and False Claims Act). Help ensure investigative practices remain current and compliant.Support Compliance activities related to conflict-of-interest disclosure review and response.Ensure confidentiality of sensitive business and patient information. Maintain records consistent with OptionCare Health policy and Compliance Department processes.Support compliance integration initiatives with new business models.Supervisory Responsibilities(i.e. hiring, recommending/approving promotions andpay increases, scheduling, performance reviews,discipline, etc.)NoBasic Education and/or Experience RequirementsBachelor’s degree or Associate degree, preferred in healthcare, business, legal, justice , or related field.Minimum 4-6 years of progressive experience in investigations, healthcare compliance, or risk management,including at least 2-4 years in a role overseeing or conducting investigations.Basic QualificationsStrong investigative skills and experience, including interviewing, evidence analysis, attention to detail, andgood judgment. Ability to conduct thorough, objective and complex investigations, analyze complex data sets,and draw actionable conclusions.Knowledge of healthcare laws and regulations, including billing and coding, privacy and security, and fraud,waste and abuse (e.g., HIPAA, Anti-Kickback, Stark, Medicare and Medicaid reimbursement). Experienceassessing compliance with applicable laws, regulations, standards, and internal policies.Experience interacting with senior management, legal counsel, federal and state regulators, and lawenforcement.Excellent communication and interpersonal skills, with the ability to build relationships, influence stakeholders,and clearly communicate investigative findings.Experience identifying operational issues and recommending effective solutions.Experience managing multiple investigations simultaneously, prioritizing work effectively, and providingregular status updates to leadership.Strong analytical, problem-solving, and critical-thinking skills.Self-motivated, accountable for personal growth, and supportive of others’ development, while fostering aninclusive team environment and engaging in continuing education opportunities and connection.Ability to handle sensitive and confidential information with professionalism.Intermediate level skill in Microsoft Excel, Microsoft Word and Microsoft PowerPointPhysical Demand RequirementsAbility to sit and work on a computer for extended periods of time.Travel Requirements: (if required)Willing to travel up to 25% of the time for business purposes (within state and out of state).Preferred Qualifications & Interests (PQIs)Certified in investigation tactics, interviewing, fraud examination, and/or compliance (e.g., CFE, AHFI, CHC,CPCO)Advanced degree (e.g., JD, MBA, MPH) or clinical certificationAt least 2 years of direct experience in a compliance role for home infusion services, pharmacy, nursing, orlarge payor organization..At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care regulatoryrequirements.Experience using common third-party software solutions for Compliance and Privacy program management ofincidents, investigations, monitoring and exclusion screening (such as Navex, internal case managementsystems, etc.)Due to state pay transparency laws, the full range for the position is below:Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.Pay Range is $112,439.64-$187,406.90**Benefits:**-Medical, Dental, & Vision Insurance-Paid Time off-Bonding Time Off-401K Retirement Savings Plan with Company Match-HSA Company Match-Flexible Spending Accounts-Tuition Reimbursement-myFlexPay-Family Support-Mental Health Services-Company Paid Life Insurance-Award/Recognition Programs*Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.*For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, #J-18808-Ljbffr
Itasca, ILtime type:
Full timeposted on:
Posted Todayjob requisition id:
R34040**Extraordinary Careers. Endless Possibilities.****With the nation’s largest home infusion provider, there is no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.**Job Description Summary:**The Manager, Compliance Operations & Investigations supports Option Care Health’s compliance investigation
program by managing investigations from intake through resolution, including allegations received through
established reporting channels. The role conducts root cause analyses, helps implement and track corrective
actions, identifies trends and systemic issues, and provides guidance and reporting to stakeholders. The
Manager collaborates with cross-functional partners to route matters appropriately, resolve issues efficiently,
mitigate compliance risk, and supports the maintenance of investigation, corrective action, and related
compliance polies and procedures in alignment with applicable laws and regulations.**Job Description:** Conduct investigations into fraud, waste, abuse, and other compliance concerns, ensuring thorough, objectiveanalysis and documentation.Support management of the company’s confidential Ethics & Compliance Hotline including intake, casemanagement workflow, reporting, analytics, and vendor relationships.Maintain accurate case records in the Compliance case management system.Develop, implement, and maintain investigation strategies, policies and processes to identify and addresspotential violations of laws, regulations, and internal policies.Collaborate with cross-functional partners to assess, triage, and route investigative matters for appropriateresolution and risk mitigation. Consult with Legal on compliance-related legal issues and timely communicaterelevant statutory, regulatory or policy changes to business unit leadership.Conduct root cause analysis and implement corrective actions. Monitor and track remediation completion.Prepare and present investigation reports to leadership and regulatory authorities, as necessary.Provide guidance on compliance policies, procedures, and best practices and foster a culture of ethical conduct and non-retaliation.Maintain current knowledge of relevant healthcare laws and regulations (e.g., HIPAA, Stark Law, Anti-KickbackStatute, and False Claims Act). Help ensure investigative practices remain current and compliant.Support Compliance activities related to conflict-of-interest disclosure review and response.Ensure confidentiality of sensitive business and patient information. Maintain records consistent with OptionCare Health policy and Compliance Department processes.Support compliance integration initiatives with new business models.Supervisory Responsibilities(i.e. hiring, recommending/approving promotions andpay increases, scheduling, performance reviews,discipline, etc.)NoBasic Education and/or Experience RequirementsBachelor’s degree or Associate degree, preferred in healthcare, business, legal, justice , or related field.Minimum 4-6 years of progressive experience in investigations, healthcare compliance, or risk management,including at least 2-4 years in a role overseeing or conducting investigations.Basic QualificationsStrong investigative skills and experience, including interviewing, evidence analysis, attention to detail, andgood judgment. Ability to conduct thorough, objective and complex investigations, analyze complex data sets,and draw actionable conclusions.Knowledge of healthcare laws and regulations, including billing and coding, privacy and security, and fraud,waste and abuse (e.g., HIPAA, Anti-Kickback, Stark, Medicare and Medicaid reimbursement). Experienceassessing compliance with applicable laws, regulations, standards, and internal policies.Experience interacting with senior management, legal counsel, federal and state regulators, and lawenforcement.Excellent communication and interpersonal skills, with the ability to build relationships, influence stakeholders,and clearly communicate investigative findings.Experience identifying operational issues and recommending effective solutions.Experience managing multiple investigations simultaneously, prioritizing work effectively, and providingregular status updates to leadership.Strong analytical, problem-solving, and critical-thinking skills.Self-motivated, accountable for personal growth, and supportive of others’ development, while fostering aninclusive team environment and engaging in continuing education opportunities and connection.Ability to handle sensitive and confidential information with professionalism.Intermediate level skill in Microsoft Excel, Microsoft Word and Microsoft PowerPointPhysical Demand RequirementsAbility to sit and work on a computer for extended periods of time.Travel Requirements: (if required)Willing to travel up to 25% of the time for business purposes (within state and out of state).Preferred Qualifications & Interests (PQIs)Certified in investigation tactics, interviewing, fraud examination, and/or compliance (e.g., CFE, AHFI, CHC,CPCO)Advanced degree (e.g., JD, MBA, MPH) or clinical certificationAt least 2 years of direct experience in a compliance role for home infusion services, pharmacy, nursing, orlarge payor organization..At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care regulatoryrequirements.Experience using common third-party software solutions for Compliance and Privacy program management ofincidents, investigations, monitoring and exclusion screening (such as Navex, internal case managementsystems, etc.)Due to state pay transparency laws, the full range for the position is below:Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.Pay Range is $112,439.64-$187,406.90**Benefits:**-Medical, Dental, & Vision Insurance-Paid Time off-Bonding Time Off-401K Retirement Savings Plan with Company Match-HSA Company Match-Flexible Spending Accounts-Tuition Reimbursement-myFlexPay-Family Support-Mental Health Services-Company Paid Life Insurance-Award/Recognition Programs*Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.*For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, #J-18808-Ljbffr