Manager of Compliance, WelbeHealth
Program Integrity
$109.2-144.2k
+ Bonus
At-home healthcare for the elderly
Job no longer available
At-home healthcare for the elderly
501-1000 employees
Job no longer available
$109.2-144.2k
+ Bonus
501-1000 employees
Company mission
To help seniors thrive and live longer with greater connection, vitality, and meaning.
Role
Who you are
- 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
What the job involves
- 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
- 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
- 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
Our take
Healthcare and insurance can be tricky to navigate, especially for the eldest and most vulnerable. That's what WelbeHealth aims to change with its healthcare management program for seniors.
It markets its program as ‘PACE’ - that’s Program of All-inclusive Care for the Elderly - which means that once a patient signs up, WelbeHealth coordinates and pays for all their healthcare, taking pressure off the patient and caregivers. It’s covered under Medicare and Medi-Cal and puts a strong focus on coordinating support to help patients stay at home and remain an active part of their community.
There’s a wide market for healthcare management, particularly healthcare for seniors. WelbeHealth’s offer has raised impressive funds and seen solid growth and community impact. In 2023, it bolstered its growth with new hires in key leadership positions, indicating its attractiveness for medical science and technology leaders.
Steph
Company Specialist at Welcome to the Jungle
Insights
26% employee growth in 12 months
Company
Funding (last 2 of 4 rounds)
Feb 2020
$30m
SERIES C
Jun 2018
$15m
SERIES B
Total funding: $61.2m
Company benefits
- TIME TO RECHARGE: We believe in healthy and refreshed employees. That’s why full-time employees get 17 days of paid time off in year one, 12 company holidays and 5 sick days
- EQUITY PARTICIPATION RIGHTS FOR ALL: Our success is a reflection of our employees. That’s why we’ve implemented a best practice from leading companies: Equity Grants for all employees
- COMPREHENSIVE BENEFITS: We’ve got you covered! Health, dental, vision and life insurance coverage. Paid parental leave. 401k matching program. Continuing Medical Education opportunities
Company HQ
Downtown Menlo Park, Menlo Park, CA
Leadership
Adam Groff
(Co-Founder)Co-founded Calibrater Health, GoHealth Urgent Care and Better Life Partners, and work at Dartmouth Hitchcock Medical Centre.
Si France
(Co-Founder & CEO)Former Engagement Manager at McKinsey, and co-founder & CEO of GoHealth Urgent Care.
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