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Compliance Manager - Program for All-Inclusive Care for the Elderly (PACE)

Job Description

Impact Lives, Impact Community

Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 62 sites, over 227,000 patients, and over 417,000 visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff.

Family Health Centers of San Diego (FHCSD) is currently seeking a Compliance Manager for our Program for All-Inclusive Care for the Elderly (PACE). The PACE Compliance Manager ensures compliance with all federal (Centers for Medicare and Medicaid Services [CMS]), state (Department of Health Care Services [DHCS]), and other applicable regulations for the FHCSD PACE program. This includes developing and maintaining a compliance program, performing risk assessments, audits, and ensuring regulatory submissions. The manager will coordinate compliance actions, train staff on regulatory standards, and proactively identify and mitigate risks.

Responsibilities:

  • Ensuring compliance with Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), and other applicable regulations.
  • Conducting compliance risk assessments and operational audits.
  • Tracking and coordinating audit items and regulatory reports.
  • Providing training to staff on policies and regulatory standards.
  • Monitoring regulatory updates and implementing necessary changes.
  • Identifying compliance risks and ensuring fiscal accountability.

Key Duties:

  • Monitor and assess regulatory updates from Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), and other regulatory bodies.
  • Evaluate the impact of regulatory changes on operations and finances.
  • Conduct audits of claims, documentation, and processes.
  • Perform regular risk assessments to identify compliance risks.
  • Maintain a master calendar of compliance deadlines.
  • Develop measures to prevent, detect, and correct fraud, waste, and abuse (FWA).
  • Support audit preparation and manage survey/audit responses.
  • Ensure documentation meets Centers for Medicare and Medicaid Services (CMS) and Department of Health Care Services (DHCS) standards and financial requirements.
  • Prepare audit reports for leadership and address compliance deficiencies.

Requirements:

  • Bachelor's degree in business, healthcare, or a related field.
  • 5 years' experience in healthcare or clinical setting; PACE experience preferred.
  • Strong organizational and time management skills.
  • Knowledge of medical terminology, coding (Current Procedural Terminology [CPT], Healthcare Common Procedure Coding System [HCPCS], and International Classification of Diseases [ICD-10]), and compliance tools (Microsoft Excel, Word, etc.).
  • Excellent verbal and written communication skills.
  • Ability and means to travel between locations on an as needed basis.
  • Requires an active California driver's license for the class required for operation of assigned vehicle; DRIVER REQUIREMENTS: Age 21; Licensed for a minimum of 3 years; No violations and/or accidents within 3 years; No vehicle related suspensions/reinstatements; No DUI, reckless or felony Driving within 7 years.

Rewards:

  • Salary of $83,000-$104,000 (DOE)
  • Retirement Plan with a 50% Employer Match
  • Paid Time Off, Extended Sick Leave and Paid Holidays
  • Medical/Dental/Vision/FSA/Life Insurance
  • Employee Discounts and Wellness Program

Location Details

  • Hours: Monday through Friday, 8am - 4:30pm
  • Address: 3420 College Avenue, San Diego, CA 92115
  • FHCSD PACE Website: https://fhcsdpace.org/services/
  • Location Website: FHCSD PACE - College Grove | Clinic Locations

#IndPACE

In the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits or potential bonuses.

71,386.00 - 101,887.00

If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and/or experience. In addition to these factors - we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here: FHCSD Wellness - Employee Hub (gobenefits.net)


Family Health Centers of San Diego complies with applicable Federal civil rights laws and does not discriminate, exclude people or treat them differently on the basis of race, color, national origin, religion, physical and mental disability, sex, including pregnancy, childbirth and related medical conditions, age, genetic information, language preference/ability, citizenship status, marital status, sexual orientation and gender identity, AIDS/HIV, medical condition, political activities or affiliations, military or veteran status, or status as a victim of domestic violence, assault, or stalking.

 

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