Manager, Compliance (Program Integrity)

At WelbeHealth, we serve our communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus lead the way no matter what. The Manager, Compliance is accountable for developing, implementing, and managing the enterprise-wide Fraud, Waste, and Abuse (FWA) Prevention Program. Reporting to the Senior Director, Corporate Compliance, this role is responsible for ensuring compliance with regulatory requirements, supporting audits and investigations, developing compliance training and corrective action plans (CAPs), and providing guidance on program integrity and operational compliance initiatives. This role is different because the Manager, Compliance at WelbeHealth: Leads and evolves our enterprise-wide FWA Prevention Program, serving as the organization's subject matter expert on program integrity while driving proactive strategies that strengthen regulatory compliance, reduce organizational risk, and protect the resources that support our participants Partners with leaders across Compliance, Operations, Legal, and Clinical teams to investigate complex FWA matters, implement sustainable CAPs, and build a culture of accountability, integrity, and continuous compliance throughout a growing, mission-driven healthcare organization We care about our team members. That’s why we offer: Medical insurance coverage (Medical, Dental, Vision) Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days 401K savings + match Comprehensive compensation package including base pay and bonus And additional benefits! On the day-to-day, you will: Lead ongoing development, coordination, and oversight of the WelbeHealth FWA Prevention Program, including the prevention, detection, documentation, investigation, and resolution of potential FWA across WelbeHealth operations Partner and coordinate with operational leadership to ensure alignment with all federal and state program integrity requirements, as well as industry best practices Collaborate with Compliance leadership to establish, update, and maintain policies, procedures, and monitoring systems supporting FWA prevention and compliance Provide subject-matter expertise and guidance to internal stakeholders on regulatory compliance matters related to FWA prevention and operations Develop and deliver FWA prevention training programs for team members at all levels Develop and maintain relationships with external entities, including CMS, law enforcement, vendors, and partner agencies, related to investigations and reporting requirements Collaborate with internal auditors, legal counsel, and operational teams to support internal and external audits and investigations, ensuring timely and accurate responses, as well as track, analyze, and report on program integrity metrics, trends, and outcomes to the Senior Director, Corporate Compliance and oversight bodies as appropriate Job requirements include: Bachelor’s degree in healthcare administration, business administration, law, compliance, or a related field required Advanced degree or professional certification such as Certified in Healthcare Compliance (CHC), Certified Fraud Examiner (CFE), or Certified in Healthcare Privacy and Compliance (CHPC) preferred Minimum of five (5) years of experience in a relevant field such as healthcare compliance, program integrity, FWA prevention, or fraud investigation oversight within a managed care or Medicare environment In-depth knowledge of federal and state Medicare and Medicaid FWA regulations and healthcare compliance frameworks Experience leading or conducting complex investigations including data analysis, documentation, and reporting Strong ability to build effective cross-functional relationships with operational and leadership stakeholders We are seeking a Manager, Compliance who is passionate about protecting the integrity of healthcare programs while advancing a culture of ethics, accountability, and regulatory excellence. The ideal candidate brings deep expertise in FWA prevention, strong investigative and analytical skills, and the ability to build trusted partnerships across the organization. If you're looking for an opportunity to make a meaningful impact by helping safeguard the care and resources that support vulnerable seniors, we'd love to hear from you. Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications. Compensation Offering $109,240.54 — $144,197.50 USD COVID-19 Vaccination Policy At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations. Our Commitment to Diversity, Equity and Inclusion At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law. Beware of Scams Please ensure your application is being submitted through a WelbeHealth