Compliance Manager, Healthcare

Join Our Team! Job Summary

Join our team as a Compliance Manager and play a vital role in maintaining our organization's commitment to compliance and integrity. With your expertise in healthcare regulations, analytical prowess, and exceptional writing skills, you'll help shape our compliance policies, procedures, and training programs.

$35-$40 per hour

Non-Exempt, Full-Time

Monday-Friday 9:00am to 5:30pm

2403 Professional Dr, Santa Rosa, CA 95403

required for this position.

• Serve as Chair of the Compliance Committee and the Utilization Review Committee (URC).
• Provide functional oversight of compliance, quality assurance, utilization review, and audit-related activities (direct supervision as assigned).
• Work collaboratively with executive leadership, program managers, and department leads to implement corrective actions and system improvements.
• Support a culture of accountability, transparency, and continuous compliance across the organization.

• Serve as the designated Compliance Officer for Center Point DAAC.
• Oversee, monitor, and coordinate the implementation and ongoing maintenance of the organization's Compliance Program.
• Lead compliance initiatives agency-wide in alignment with federal, state, county, and payer requirements.
• Prepare and present regular reports on compliance activities, investigations, audits, trends, and risk areas to the CEO and Board of Directors.
• Periodically review, revise, and update the Compliance Program, policies, and procedures to reflect regulatory, contractual, and operational changes.

• Ensure organizational compliance with applicable federal and state health care laws, including fraud, waste, and abuse regulations.
• Oversee compliance with Drug Medi-Cal Organized Delivery System (DMC-ODS) requirements, Medi-Cal standards, California Title 9, Title 22, and county contracts.
• Monitor and support compliance with OSHA, workplace safety, and operational regulatory requirements.
• Review contracts, financial arrangements, marketing initiatives, and business practices for potential compliance risk.
• Coordinate compliance oversight related to independent contractors, vendors, and external partners.
• Review and report client grievances per County regulatory requirements.

• Chair and oversee the Utilization Review Committee (URC) in accordance with adopted policies and procedures.
• Ensure services meet medical necessity standards, are consistent with ASAM Criteria, and are supported by appropriate clinical documentation.
• Collaborate with the Clinical Director and Program Managers to address utilization patterns, level-of-care determinations, and documentation issues.
• Identify, mitigate, and expedite billing, documentation, and utilization risks as appropriate.

• Develop, coordinate, and deliver compliance education and training for staff, leadership, and relevant contractors.
• Promote and maintain mechanisms for reporting compliance concerns without fear of retaliation, including anonymous reporting where appropriate.
• Oversee systems for receiving, documenting, investigating, and resolving compliance complaints or concerns.
• Maintain accurate and confidential records of compliance reports, investigations, corrective actions, grievances, and interactions with government agencies.

• Conduct or oversee internal compliance audits, monitoring activities, and targeted reviews.
• Identify compliance risk areas and recommend appropriate corrective actions and system improvements.
• Coordinate internal investigations of suspected violations in collaboration with leadership, Human Resources, and legal counsel as appropriate.
• Recommend disciplinary or corrective actions in accordance with organizational policies and applicable laws.
• Monitor follow-up and resolution of identified compliance issues to ensure timely and effective remediation.

• Oversee and coordinate organizational compliance related to Department of Health Care Services (DHCS) licensing and certification requirements, including initial licensure, certification, renewals, and ongoing regulatory compliance.
• Serve as the primary compliance lead for DHCS Substance Use Disorder (SUD) program licensing and certification, ensuring adherence to Title 9, DMC
  * ODS, and applicable county requirements.
• Coordinate preparation for and response to DHCS licensing visits, certifications, audits, corrective action plans, and follow-up reviews, in collaboration with executive leadership, clinical leadership, and program management.
• Monitor regulatory changes issued by DHCS and recommend policy, procedural, or operational updates to maintain compliance.
• Ensure required documentation, policies, and records related to DHCS licensing and certification are…