The Senior Compliance Specialist (Project Mngr.) serves as a subject matter expert, driving the development and implementation of best practices in ethical interactions with healthcare providers, appropriate billing standards, and the continuous evolution of an effective compliance program.

This role requires strategic collaboration with business stakeholders to identify and understand compliance requirements, assess risks, and recommend process improvements and controls that uphold regulatory standards that includes: policy development, compliance management, auditing & monitoring, compliance education, special projects, industry awareness, and risk assessments.

This role demands attention to detail, strong organizational skills, and the ability to foster a proactive, collaborative culture that prioritizes compliance and ethical integrity.

1. Policy Management – Oversee the compliance policy database by developing and updating policies, monitoring regulatory changes, troubleshooting system issues, and providing user training.
2. Regulatory Research & Risk Assessment – Investigate compliance regulations, conduct ongoing risk assessments within the health system, and collaborate with leadership to develop quarterly and annual compliance work plans.
3. Project Leadership– Oversee and lead projects focused on ensuring regulatory compliance with special focus in long-term care, behavioral health, and inpatient rehabilitation, serving as a subject matter expert to guide adherence to industry standards.
4. Special Projects Oversight – Manage key compliance-related projects, supporting compliance leadership in strategic initiatives.
5. Project Investigations - Provide strategic guidance in investigating suspected violations of laws, government regulations, and internal policies, driving resolution and continuous improvement.
6. Investigation & Resolution – Examine reported compliance concerns, coordinate corrective measures, and ensure ongoing adherence to regulatory standards
7. Auditing & Monitoring – Plan and conduct audits, enforce and track corrective actions, and prepare compliance reports to maintain regulatory integrity.
8. Relationship Building & Collaboration – Foster strong partnerships across departments to promote a proactive and balanced approach to compliance program implementation.
9. Health System Rounding – Conduct routine compliance rounds across the health system to reinforce policy adherence and operational standards.
10. Industry Trend Analysis – Maintain up-to-date knowledge of industry best practices, emerging trends, and evolving laws affecting healthcare compliance.
11. Regulatory Monitoring – Track ongoing regulatory trends and Office of Inspector General guidelines, identifying potential risk areas within healthcare operations and communicating these updates effectively.
12. Complex Issue Analysis & Communication – Interpret complex regulations, translating them into clear compliance expectations for employees across all levels of the organization.
13. Procedure & Schedule Development – Establish workflows, set priorities, and design programs to meet audit and compliance objectives.
14. Project Management & Strategic Planning – Utilize project management tools to track progress and ensure compliance goals are met efficiently.
15. Advanced Compliance Reporting – Prepare written compliance communications and formal reports using advanced writing skills to support transparency and accountability.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

1. Bachelor's degree in nursing, healthcare, or a related field required.
2. Minimum of five years in a healthcare-related role.
3. Background in Long-Term Care and/or Behavioral Health is preferred.
4. Certified in Healthcare Compliance (CHC) and Certified in Healthcare Privacy Compliance (CHPC) or advanced education preferred.
5. Must adhere to the Code of Ethics for Health Care Compliance Professionals established by the Health Care Compliance Association (HCCA).
6. Excellent verbal, written, and presentation skills required.
7. Ability to engage effectively with various levels of management and staff within the health system.
8. High level of discretion, ethical conduct, and trustworthiness.
9. Ability to multi-task and prioritize assignments.
10. Familiarity with HIPAA, state, and federal guidelines.
11. Proficiency with personal computers and typical office software, including Windows, Word, Excel, PowerPoint, and Access. Ability to learn new departmental software.
12. Strong teamwork, collaboration, and analytical skills to achieve goals.
13. Must be able to read, write legibly, speak, and comprehend English.

WORKING CONDITIONS

WORK CONTEXT

• Interpersonal Relationships – Daily contact with others through face-to-face discussions, electronic mail, and telephone. Frequently coordinates and leads others, works with a group or team, deals with internal and external customers (including occasional unpleasant or angry people), participates in conflict situations/resolutions, produces results, and draft letters, memos and reports to document activities.  
• Physical work conditions – Works primarily indoors in a controlled environment sitting at a computer or workstation.
• Structural job characteristics – Regular work schedules with occasional requirements to be available to accommodate employees on other shifts. High degree of freedom to make decisions that affect other people, as well as the image and reputation of the organization.  Extremely important to be exact and accurate based on the seriousness/consequence of errors. 

PHYSICAL FACTORS

• Ability: The ability to bend, stretch, twist, or reach with your body, arms, and/or legs.
• Activities: Talking, hearing, bending, twisting, walking, kneeling, crouching, stooping, reaching, pushing, pulling, lifting, grasping, repetitive motion, standing, and/or using hands to handle, control, or feel objects, tools or controls.
• Requirements: Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Involves sitting most of the time. Walking and standing are required only occasionally and all other sedentary criteria are met.
• Must be able to perform the duties with or without reasonable accommodation.
• Hearing and vision must be normal or corrected to within normal range.
• Physical presence onsite is essential.

OTHER JOB FACTORS

• Requires the following cognitive abilities: deductive and inductive reasoning, flexibility of closure, fluency of ideas, information ordering, mathematical reasoning, memorization, number facility, oral comprehension and expression, originality, problem sensitivity, selective attention, speed of closure, time sharing, visualization, and written comprehension and expression.
• Requires the following psychomotor abilities: finger and manual dexterity.
• Requires the following sensory abilities: speech clarity and recognition.
• Requires the following personal characteristics/work styles: integrity, initiative, leadership, dependability, achievement/effort, adaptability/flexibility, analytical thinking, concern for others, cooperation, independence, innovation, persistence, self control, social orientation, stress tolerance and attention to detail.
• Position satisfies each of the following work values: achievement, independence, recognition, relationships, support, and good working conditions.