Compliance Program Administrator

Overview

Job Opportunity

Compliance Program Administrator – St. Jude Children's Research Hospital

262 Danny Thomas Place, Memphis, Tennessee 38105

Location:

Memphis

Hours:

Full-Time

Contact:
Emma Randall

Category: Health Industry

Posted: Jan 14, 2026

Updated: Jan 14, 2026

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We are seeking a highly skilled and detail-oriented Compliance Program Administrator with a strong background in hospital billing compliance to join our Healthcare Compliance team. The ideal candidate will have at least five (5) years of experience in hospital billing compliance, with in-depth knowledge of Medicaid Recovery Audit Contractor (RAC) processes, payer guidelines, and the regulatory frameworks governing healthcare reimbursement.

This role plays a critical part in ensuring that our institution maintains full compliance with federal and state regulations, payer requirements, and internal policies related to billing, coding, and documentation.

• Lead and manage the hospital billing compliance program across inpatient and outpatient services. Perform risk-based evaluations of internal and external compliance trends to inform program focus areas. Monitor and interpret Medicaid Recovery Audit Contractor (RAC) activity, including appeals and corrective actions. Ensure adherence to payer-specific guidelines, including Medicare, Medicaid, and commercial payers. Experience with clinical research billing guidelines is preferred. Conduct internal audits, monitor activities, and risk assessments to identify billing and coding discrepancies.
  
  Collaborate with Revenue Cycle, Revenue Integrity, Health Information Management Services (HIMS), and clinical departments to resolve compliance issues. Establish and maintain a role as a trusted partner and subject matter expert with key stakeholders and compliance collaborators. Develop and deliver training programs on billing compliance, RAC audits, and payer regulations. Maintain current knowledge of CPT, HCPCS, ICD-10, and other coding standards.
  
  Prepare and present compliance reports to senior leadership. Support responses to external audits and regulatory inquiries. Assist in policy development and updates based on regulatory changes and institutional needs. Support other strategic and operational initiatives of the Compliance Office.

• Minimum of five (5) years of directly applicable compliance experience (e.g., governance, auditing and monitoring, training, risk assessment, investigation of compliance concerns, and action recommendations). Prior compliance program management experience required. Demonstrated record of success and proven performance in previous compliance roles.
• Preferred Qualifications Independent and experienced in the hospital billing space Strong knowledge of Medicaid and payer guidelines Background in clinical research billing Experience in billing compliance Certified Professional Coder (CPC) Certified Compliance Specialist (CCS) Licensure, Registration, and/or Certification Required by SJCRH Only One of the following licenses or certifications must be obtained within two (2) years of employment: RHIA:
  Registered Health Information Administrator CHC:
  Certified in Healthcare Compliance CHRC:
  Certification in Healthcare Research Compliance CHPC:
  Certification in Healthcare Privacy Compliance CCEP / CCEP-I:
  Certified Compliance & Ethics Professional / Certified Compliance & Ethics Professional – International CCS:
  Certified Compliance Specialist CPCO:
  Certified Professional Compliance Officer CCP:
  Certified Compliance Professional CIPP:
  Certified Information Privacy Professional CQA:
  Certified Quality Auditor CQE:
  Certified Quality Engineer CIA:
  Certified Internal Auditor (LC: RN-TN) Must possess a current Tennessee State Board of Nursing license if the primary residence is Tennessee or a non-Compact state. (LC: RN-ARK or RN-MISS) Must possess a current State Board of Nursing license in the state of primary residence if the state is a Nurse Licensure Compact state. (LC: NBCRNA) Certification by the National Board of Certification and Recertification of Nurse Anesthetists.
  
  (LC: APN-TN) Must possess a…