The Business Compliance Manager will work closely with the Business Compliance Director to support compliance initiatives and enhance Aledade’s commitment to ethical practices and a proactive adherence to regulatory requirements. This role will focus particularly on compliance issues related to new business initiatives, especially those involving alternate payment models to operationalize regulatory and contractual requirements in order to meet business objectives. The Business Compliance Manager will help assess risks, implement compliance programs, and foster a culture of compliance throughout the organization. Additionally, the Business Compliance Manager will work closely with Aledade’s Legal-Regulatory team to provide compliance support, synthesizing complex regulatory requirements to provide the business with actionable compliance requirements.
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or be based from Bethesda, MD office.
Primary Duties:
Compliance Point of Contact: Act as the compliance point of contact for new Aledade alternate payment model initiatives with an ability to provide appropriate compliance guidance; Stay up-to-date on changes in laws, regulations, and internal policies and work closely with organization departments to ensure compliance with them; Assist in identifying and managing compliance requirements in contracts with new vendors; Provide guidance to questions received through the Compliance mailbox system for business related concerns and questions.
Health System Contractual Commitments: Coordinating across departments, and implementing compliance mechanisms to ensure compliance obligations/agreed terms are being met.
Cross-Departmental Leadership and Committee Reporting: Assist in the identification and implementation of Compliance monitoring activities; Support the Business Risk Oversight Compliance Sub-Committee in areas like Coding and Billing, Quality, and alternate payment model compliance; Collaborate with Compliance leadership to assess current program maturity levels and identify opportunities for enhancement; Help identify and assess compliance risks, and develop strategies to mitigate them.
Program Implementation: Assist the Business Compliance Director in the continued implementation of the Corrective Action and Preventive Action and the Practice Partnership Integrity Programs.
Accountable Care Organization Compliance: Assist in the continued development of compliance programs and procedures to ensure compliance with all applicable laws, regulations, and internal policies related to value-based care through governmental programs and contracts with commercial payers; Provide and track Compliance training and education to the Aledade Accountable Care Organizations.
Minimum Qualifications:
Bachelor's degree in a relevant field (Healthcare Administration, Finance, etc.) or equivalent combination of education and experience.
Minimum of 5 years of progressive experience in the healthcare industry with a strong focus on healthcare compliance program management, monitoring, auditing, or a combination of these areas.
Strong knowledge of healthcare regulations, including HIPAA and fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).
Exceptional written and verbal communication skills, with the ability to translate complex data findings into clear and actionable guidance.
Strong interpersonal skills and the ability to collaborate effectively with diverse teams.
Ability to work independently or as part of a team.
Demonstrated capability to render risk and business-based decisions in areas lacking explicit regulatory guidance.
Preferred knowledge, skills, and/or abilities:
Understanding of healthcare regulations, including those specific to Accountable Care Organizations (ACOs) and value-based care models (e.g., MSSP, Direct Contracting).
Compliance certification (e.g., CHC, CCEP).
Experience with compliance management software or platforms.
Experience working in a rapidly growing organization or startup environment.
Familiarity with compliance program maturity models (e.g., OIG Seven Elements, DOJ Guidelines).
Proficiency in G-Suite or Microsoft Office Suite.
Physical Requirements:
Prolonged periods of sitting at a desk and working on a computer.
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
