Business Partner Compliance Program Manager

P3 Health Partners is committed to ensuring the health and safety of our team members, patients and communities we serve. As a part of this commitment, all candidates must receive their COVID-19 vaccine prior to joining the team. If you have any questions about our interview and hiring procedures, please contact PeopleServices@p3hp.org.

People. Passion. Purpose.

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.

We are looking for a Business Partner Compliance Program Manager. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Las Vegas, Nevada, then you should consider joining our team.

Business Partner Compliance Program Manager

Overall Purpose:

Reporting to the P3HP Compliance Officer, the Business Partner Compliance Manager is responsible for overseeing P3HP compliance with established Accountable Care Organization (ACO) standards and regulations, as well as support the P3HP Market Presidents with maintaining compliance with applicable Federal and State requirements for all P3HP Market business functions.

Must have healthcare setting compliance program knowledge, including federal and state regulations, as well as a solid working knowledge of managed care operations, and compliance program structures. Must have the highest level of integrity and ethics and demonstrate professional representation of the company.

Education and Experience:

• Graduate degree in a field directly related to the business needs of this position and/or a Nursing Degree, MBA, JD or the equivalent of professional experience

• 3-5 years of experience in clinical or provider setting compliance programs (managed care), or within a large provider group or outpatient setting (i.e.: ACO, FQHC)
• 5-10 years of management experience
• Strong working knowledge of Medicare and Medicaid structure and member population needs

• Health Care industry compliance certification such as CHC, CHC-F, CHRC, CHPC, CCEP

Knowledge, Skills, and Abilities:

• Ability to effectively analyze data, make decisions and implement recommendations for compliance program improvements
• Demonstrated organizational agility; able to manage up and manage down, acting as a liaison to drive strategy and achieve organizational goals
• Entrepreneurial and operational mindset to create compliance program efficiencies and support specifically for P3HP Markets
• Excellent written, computer, and oral communication skills – will proactively and thoroughly communicate with other members of the team
• Strong focus on an ethical culture, employee engagement, and performance management

Essential Functions

Compliance:

• Support ACO re-procurement/implementation activities related to the compliance program
• Provide support to P3HP Markets for the purpose of maintaining compliance with applicable state and federal regulations and health plan contract requirements
• Coordinate with P3HP Markets to ensure implementation of any new requirements including revising policies and procedures, and the development of targeted trainings as needed
• Participate in Market Leadership meetings and activities
• Provide recommendations and feedback to the P3HP Compliance Officer for risk assessment activities including the identification of risks and recommendations for issues that directly impact the P3HP Markets
• Assist with overseeing compliance with Federal and State licensure requirements in the Markets
• Travel required to all P3HP Markets

Compliance Job Accountabilities:

• Act as liaison between P3HP Shared Services Compliance Team, and the P3HP Markets to ensure successful and consistent execution of the P3HP Compliance and Privacy Programs
• Develop, review, and coordinate implementation of P3HP Shared Service, and Market based policies, procedures, and work instructions to address and mitigate areas of operational and regulatory risk
• Measure Market adherence to, and effectiveness of the P3HP Compliance & Privacy Programs through monitoring and managing Market KPIs
• Recommending compliance and privacy program improvement strategies on behalf of the Markets
• Represent the P3HP Compliance Team during Market leadership meetings, and other related activities
• Train Market staff on the P3HP Compliance & Privacy Program as needed
• Coordinate with the P3HP Compliance Officer on any investigations that involves Market employees or processes
• Coordinate with the P3HP Compliance Manager responsible for the P3HP Privacy Program as needed including for processing records requests, responding to accounting of disclosures, reviewing authorization and revocation forms, conducting desk audits, conducting targeted trainings, participating in privacy investigations, and conducting auditing activities
• Support product and service expansion across markets as it relates to the P3HP Compliance and Privacy Programs.
• Develop and foster the P3HP compliance and ethics culture in all P3HP Markets, promoting an atmosphere of engagement, trust, and open dialogue
• Ensures Market compliance with federal and state regulations and company policies, procedures, and processes