The Sr. Compliance Principal applies broad expertise and knowledge in specialized fields to serve as an internal subject matter expert for Included Health on all matters related to compliance. You will lead and contribute to the development of our goals and principles, providing expert guidance on significant, unique issues where analysis requires an evaluation of intangibles. You will be accountable for results that may influence the entire function and require conceptual thinking to understand advanced issues and their possible effects. You will report into the Corporate Compliance Officer.
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Responsibilities:- Strategic Leadership & Program Evolution: Lead and contribute to the development of our goals and principles in creative and effective ways. Apply broad expertise to address significant and unique compliance issues, using conceptual thinking to understand advanced issues and their possible effects. Be an internal subject matter expert, providing expertise on broader organization projects that require an understanding of the wider business.
- Critical Risk Management:Identify and assess significant and unique compliance risks, including those related to regulatory compliance, HIPAA Privacy, billing and coding/revenue cycle, and federal/state health insurance programs. Design and implement long-term risk mitigation strategies, exercising independent judgment in the methods, techniques, and evaluation criteria for obtaining results. Conducting risk assessments and developing corrective action plans.
- Advanced Monitoring and Auditing:Provide strategic guidance and oversight for monitoring and auditing activities, using insights from these findings to inform future program design and long-term preventative measures.
- Expert Guidance & Internal Influence:Serve as the enterprise-wide subject matter expert, conveying advanced information and persuading diverse team members and audiences. Create formal networks involving coordination among various groups to achieve compliance goals. May direct the activities of others.
- Cross-Functional Impact: Work on issues where the analysis of situations or data requires an evaluation of intangibles, with accountability for results that may affect the entire function.
Qualifications:- Bachelor's degree with 12 years of relevant experience, or a Master's degree with 8 years of experience, or a PhD with 5 years of experience, or equivalent combination of education and experience.
- Extensive knowledge of theories, practices, and design matters related to healthcare compliance.
- Significant experience developing and leading critical, strategic initiatives within a compliance program.
- Experience applying healthcare compliance expertise.
- Experience creating formal networks and coordinate among groups to influence important partners across the organization.
- Experience with conceptual thinking to understand advanced issues and their possible effects.
- Recognized internally as a subject matter expert.
- Deep Regulatory Knowledge: Expert-level understanding of healthcare laws, regulations, and ethical standards, including HIPAA, CCPA, ACA 1557, the False Claims Act, and the Anti-Kickback Statute.
- Audit and Oversight: Experience developing and administering compliance audits and an understanding of data collection, analysis, and reporting mechanisms to monitor compliance efforts.
- The capacity to analyze complex data, interpret regulations, and develop effective solutions to intricate compliance issues.
Preferred Qualifications:- Expertise in government payor program compliance, such as Medicare, Medicaid, ACA and Tri-Care
- Certification in healthcare compliance (eg. CHC, CCEP) or privacy (eg. CIPP, CIPM).
- AI governance/compliance experience.
- Proficiency with compliance case management systems and platforms.
Physical/Cognitive Requirements:- Prompt and regular attendance at assigned work location.
- Ability to remain seated in a stationary position for prolonged periods.
- Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, computer, and other office-related equipment.
- No heavy lifting is expected; occasional exertion of about 20 lbs. of force (e.g., lifting a computer or laptop) may be required.
- Ability to interact with leadership, employees, and members in an appropriate and professional manner.
- Some overnight business travel will be required.
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Pay:
The United States new hire base salary target ranges for this full-time position are:
Zone A: $149,450-211,100 + bonus + equity + benefits
Zone B: $164,395-232,210 + bonus + equity + benefits
This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.
Starting base salary for you will depend on several job-related factors, unique to each candidate, which may include education; training; skills; years and depth of experience; certifications and licensure; our needs; internal peer equity; organizational considerations; and understanding of geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that all employees receive fair and great compensation package based on their roles and locations. Your Recruiter can share your geographic zone upon inquiry.
Benefits & Perks:
In addition to receiving a great compensation package, the compensation package may include, depending on the role, the following and more:
Remote-first culture
401(k) savings plan through Fidelity
Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
Paid Time Off ("PTO") and Discretionary Time Off (“DTO")
12 weeks of 100% Paid Parental leave
Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies.
Work-From-Home reimbursement to support team collaboration home office work
Your recruiter will share more about the salary range and benefits package for your role during the hiring process.
About Included Health:
Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We're on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It's all included. Learn more at includedhealth.com.
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Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.
About Included Health
Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.
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Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.
