Job Summary Required Qualifications and Skills
A direct hire opportunity is available for a Compliance Manager in San Jose, CA within the healthcare services industry. This role is responsible for helping ensure organizational policies, procedures, claims processes, and business practices align with regulatory requirements, accreditation standards, ethical expectations, and internal controls.
The Compliance Manager will play a key role in supporting senior leadership, strengthening risk management practices, guiding regulatory compliance efforts, and overseeing claims-related activities, including FTCA-related processes. This is an excellent opportunity for a compliance professional who enjoys research, policy development, audits, process improvement, and cross-functional collaboration.
This position offers the opportunity to work in a mission-driven healthcare environment with supportive leadership, professional visibility, and the ability to influence operational best practices. The role also includes supervisory responsibility for compliance team members, creating a strong opportunity for leadership growth and continued career development.
Key Responsibilities
- Develop, maintain, and oversee the claims management process for potential or actual health-related claims, including medical malpractice claims that may be eligible for FTCA coverage.
- Analyze internal business systems, policies, procedures, and operational practices to ensure compliance with federal and state regulations, accreditation standards, and ethical requirements.
- Conduct compliance reviews, audits, monitoring, testing, and initial investigations of alleged compliance violations, documenting findings and escalating issues as needed.
- Create, update, implement, and recommend policies, procedures, controls, training programs, job aids, and forms to support compliant business operations.
- Track and research regulatory changes, identify impacted departments, and coordinate with business teams to implement required operational or policy updates.
- Serve as a compliance resource for staff, leadership, and project teams by providing risk-based guidance and supporting regulatory requests, examinations, and documentation needs.
Compensation and Benefits
- Salary range: $105,000 to $120,000 per year.
- Employment type: Direct hire.
- Location: San Jose, CA.
- Oversee compliance monitoring, testing, audits, investigations, and reporting.
- Manage FTCA-related claims processes and serve as a claims point of contact.
- Research, interpret, and track federal and state laws, regulations, and regulatory guidance.
- Develop policies, procedures, controls, training recommendations, and risk management strategies.
- Four-year college degree or equivalent experience required.
- 3 to 5 years of relevant compliance, regulatory, risk management, claims management, or healthcare administrative experience preferred based on role level.
- Significant experience researching and interpreting laws, regulations, and regulatory guidance.
- Strong understanding of compliance program operations, policy development, internal controls, audits, and documentation practices.
- Experience communicating regulatory requirements to business units, staff, and leadership in a clear and practical manner.
- Ability to conduct initial reviews of potential compliance violations and escalate complex issues appropriately.
- Strong PC skills and proficiency with standard office technology and computer-based documentation.
- Excellent written and verbal communication skills.
- Strong analytical, organizational, problem-solving, and detail-oriented work style.
- Ability to work independently, manage moderately complex issues, and maintain professionalism with confidential information.
- Ability to supervise and support Compliance Specialist I and Compliance Specialist II team members.
- Ability to work in a medical, clinical, and administrative office environment, including sitting, standing, walking, typing, occasional lifting up to 25 pounds, and travel to work sites as needed.
Preferred Qualifications
- Compliance certification from a recognized trade organization, such as CUCE, NCCO, or CRCM.
- Experience working with regulatory examiners, including responding to regulatory requests, producing documents, or supporting examinations.
- Healthcare services compliance experience.
- FTCA claims management or medical malpractice claims process experience.
- Experience reviewing marketing materials, advertisements, disclosures, websites, forms, and related materials for compliance.
Equal Opportunity Employer / Disabled / Protected Veterans
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For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
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