Job Description
Job Title: Compliance Manager
Department: Clinical Administration
Reports To: Executive Leadership
Location: Sanford and DeLand, FL – Hybrid (In-office and remote)
Employment Type: Full-Time, Exempt
Salary Range: Starting at $65k
Position Summary: We are seeking an experienced and detail-oriented
Compliance Manager to lead and oversee compliance efforts across all clinical departments within our behavioral health organization. This position plays a critical role in ensuring that all clinical services meet applicable federal, state, and payer-specific regulations, particularly
Medicaid and
Medicare guidelines. The ideal candidate brings a strong understanding of behavioral health operations and is passionate about promoting clinical integrity and quality care through robust compliance standards.
Key Responsibilities: - Oversee organization-wide clinical compliance across therapy, psychiatry, psychological testing, and other clinical programs
- Develop, implement, and monitor internal compliance policies, protocols, and procedures to align with federal, state, and payer regulations
- Ensure documentation standards meet Medicaid, Medicare, and commercial insurance requirements
- Conduct regular internal audits of clinical documentation, billing practices, and service delivery
- Lead investigations into compliance issues and provide corrective action plans when needed
- Serve as the primary liaison during payer audits, site visits, or corrective action implementations
- Collaborate with department leaders and clinical supervisors to develop training materials and conduct staff training on compliance standards
- Maintain up-to-date knowledge of changes in behavioral health regulations and payer guidelines
- Report regularly to executive leadership on compliance trends, risks, and performance metrics
Required Qualifications: - Minimum of 3 years of compliance experience in a behavioral health or healthcare setting
- Demonstrated knowledge of Medicaid and Medicare regulations, particularly in a clinical behavioral health context
- Strong understanding of clinical documentation standards and quality assurance protocols
- Experience managing or conducting audits, compliance reviews, or corrective action plans
- Excellent communication and leadership skills, with the ability to engage multidisciplinary teams
- Strong technical skills with EMR systems and clinical data tracking tools
Preferred Qualifications: - Licensed Mental Health Professional (LMHC, LCSW, LMFT, or equivalent)
- Previous experience in a multi-site behavioral health organization
- Experience working with managed care organizations (MCOs) and community mental health centers (CMHCs).
- CHC Certification
- CPHQ Certification
- CPCO Certification
Work Environment & Benefits: - Collaborative, mission-driven environment focused on high-quality behavioral health care
- Competitive salary and comprehensive benefits package
- Opportunities for professional development and leadership growth
- Flexible work schedule and supportive leadership team
- Travel between offices required
- 50% In-office
Job Tags
Full time, Remote job, Flexible hours,