Healthcare Compliance Investigations Manager

Role Overview

This position offers a hybrid work arrangement, combining remote flexibility with on-site presence at our Irving, TX office two days per week.

Leads and oversees North Star’s compliance investigation function, ensuring investigations are objective, timely, consistent, and well‑documented, in accordance with state and federal laws, regulations, payer expectations, and organizational policies. Strong contributor to a best‑in‑class compliance and privacy program.

• Responsible for the compliance investigation function, including case intake of inquiries and allegations, triage, prioritization, investigation planning, documentation standards and review, resolution, report writing, follow‑up and closure.
• Conducts interviews, gathers and reviews relevant documentation, prepares investigative reports, action plans, and follow up.
• Supports compliance program staff by providing consultation on investigative strategy and executing consistent investigation practices.
• Responsibility for the preservation and investigation record‑keeping activities are performed including appropriate documentation, investigative records, analysis, and close out of all investigations in shared files and case management system.
• Evaluates and escalates allegations involving healthcare laws, regulations, payer requirements, organizational policies, privacy and security obligations, billing practices, fraud, waste and abuse, and standards of ethical conduct.
• Conducts annual compliance program awareness survey and reports results as well as implements any corrective actions identified in data analysis.
• Partners with relevant departments to ensure investigations are appropriately coordinated, resolved, and tracked.
• Recommends policy updates, education, monitoring, repayment review, disciplinary referral, or process improvements.
• Maintains and monitors investigation metrics, timelines, outcomes, and corrective action plans to support leadership reporting and oversight.
• Synthesizes complex information, performs root‑cause analysis, identifies compliance issues and trends, and translates findings into practical risk mitigation strategies that may include auditing recommendations, monitoring, education, and/or practical risk mitigation priorities.
• Supports compliance program governance by preparing investigation summaries, trend reports, and recommendations for senior leadership, compliance committees, and other oversight forums.
• Maintains current knowledge of applicable healthcare compliance requirements, including HIPAA, fraud, waste and abuse standards, federal and state healthcare program rules, and internal policies.

• Bachelor’s degree in Business, Healthcare Administration, or related field of study.
• Experience in conducting investigations in a hospital, health system, physician group, or other regulated healthcare environment, as well as competency in Healthcare Compliance.
• 2+ years of supervisory, team lead, project lead, or case management experience, preferably in a healthcare compliance or investigations environment.
• Professional certification in either healthcare compliance or investigations is required.
• Experience with compliance case management systems, audit tools, electronic health records, claims data, reporting dashboards, and data analytics.
• Knowledge of compliance risk assessment, corrective action planning, monitoring, reporting and governance practices.

• Strong judgment and objectivity when assessing sensitive matters.
• Excellent interviewing, listening and fact‑gathering skills.
• Strong written communication skills and the ability to produce clear, organized reports.
• High attention to detail and ability to manage complex information with discretion and professionalism.
• Expertise in Microsoft Office applications, including Excel, Word and PowerPoint.
• Current knowledge of applicable federal and state healthcare regulations.
• Knowledge of compliance program requirements and procedures.
• Strong critical thinking and analytical skills.
• Excellent verbal, written and presentation skills.
• Strong organizational and planning skills with the ability to manage…