Compliance program manager vs compliance specialist

Differences between compliance program manager and compliance specialist duties and responsibilities

Compliance program manager example responsibilities.

• Manage patient complaints and grievances in compliance with Medicare requirements including investigation, resolution and response.
• Manage supervisors and individual contributors conducting confidential occupational fraud, ethics and compliance investigations across multiple lines of business.
• Establish effective working relationships with hospital employees and providers promoting a culture of ethics and compliance.
• Ensure compliance with federal and state statutes, rules, and regulations regarding protect health information, including HIPAA.
• Receive ISO classification for company.
• Investigate non-compliance and HIPAA concerns resolving case matters appropriately.
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Compliance specialist example responsibilities.

• Lead bi-weekly Medicaid meetings to maintain effective communication with all staff regarding AHCA updates and notifications.
• Manage and submit regulatory permit and notification applications to USDA to import, move and release regulate plant materials.
• Participate in OCC exam preparation and review including research and presentation of documentation to achieve compliance with federal examiner requests.
• Access the IDX system to obtain patient billing information in order to review Medicare and Medicaid payments.
• Develop training materials to be used company-wide for regulatory mandate continuing education; create written policy manual for ethics and compliance.
• Perform SOX control testing and validation.
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