Option Care Health Jobs

Extraordinary Careers. Endless Possibilities.

With the nation’s largest home infusion provider, there is no limit to the growth of your career.

Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 6,000 team members including 2,900 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees.

As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a thriving workforce that is as diverse as the patients and communities we serve.

Join a company that is taking action to develop a culture that is more inclusive, respectful, engaging and rewarding for all team members. We are committed to hiring, developing, and retaining a diverse workforce.

COVID-19 Vaccine Requirements:

As a leading healthcare provider, we have an undeniable responsibility to protect the health and safety of our patients, customers and team members.

Option Care Health requires that all employees be fully vaccinated against the COVID-19 virus. If you are offered and accept a position, your employment will be contingent upon proof of vaccination, or approved medical or religious accommodation. Proof of vaccination will be required during the onboarding process; application for medical or religious accommodations will be required to be submitted within 5 business days of start date. If medical and/or religious accommodation requests are denied, you must take steps to be fully vaccinated, or your employment will be terminated.

Job Description Summary:

The Senior Manager, Compliance Auditing, Monitoring and Analytics is responsible for overseeing and conducting the Compliance program’s risk-based auditing, monitoring and analytics activities to monitor, assess, and optimize our compliance with all laws, regulations and guidelines with Federal and State programs. This role requires a strong understanding of healthcare regulations, exceptional auditing and analytical skills, and the ability to communicate complex findings effectively to stakeholders at all levels of the organization.

Reporting to the VP, Compliance & Privacy Operations, this individual develops and executes monitoring and auditing projects, to include standard, repeatable processes identifying, documenting and presenting any errors, irregularities or findings, and completion of necessary corrective actions. Partners with functional leaders and field teams to coordinate audit and monitoring activities from initiation through completion of corrective action. Serves as a resource both internally and externally regarding compliance-related issues, including the coordination of regulatory, payer or other audits. Designs and implements robust analytics and continuous monitoring strategies to prevent, detect and mitigate compliance risks. Manages and develops Compliance team members.

Job Description: ​

Job Responsibilities (listed in order of importance and/or time spent)

• Develop and implement a risk-based compliance auditing, monitoring and analytics program to assess the effectiveness of compliance controls and processes across the organization in alignment with the Compliance organizations risk assessments and workplans.

• Conduct periodic compliance audits and reviews in accordance with established Compliance workplans, focusing on key risk areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse. Coordinates with internal stakeholders to identify audit objectives, scope, and methodologies, and ensure alignment with organizational priorities.

• Perform data analysis and review of documentation to identify potential compliance issues, irregularities, or trends, and develop recommendations for corrective actions or process improvements.

• Monitor compliance with policies, procedures, and regulations through ongoing monitoring activities, including data analysis, trend analysis, and review of key performance indicators.

• Collaborate with cross-functional teams to implement corrective actions and remediation plans in response to audit findings, and track progress to ensure timely resolution. Identifies policy, procedure, and process gaps and partners with functional leaders to develop responsive corrective measures to prevent reoccurrences.

• Provide guidance and support to staff members on audit and monitoring processes, including training on audit techniques, tools, and methodologies.

• Prepare and present regular reports on audit and monitoring activities, findings, and outcomes to executive leadership and regulatory authorities as required.

• Stay informed of changes in healthcare laws and regulations, industry standards, and best practices related to compliance auditing and monitoring, and incorporate updates into audit plans and processes.

• Maintain documentation of audit and monitoring activities, including work papers, findings, recommendations, and corrective actions, in accordance with established recordkeeping requirements.

• Escalate and report serious compliance, quality or other business risks timely to functional leadership by demonstrating the ability to exercise good independent judgment in assessing the significance and relevance of identified issues.

• Collaborate with cross-functional teams to develop and implement analytics-driven, risk-based capabilities to continuously monitor compliance with internal policies and federal, state, and local regulations. Utilize advanced analytics techniques to analyze large datasets, such as related to healthcare operations, billing, claims, and patient information to support Compliance activities and to identify trends, anomalies, and potential compliance risks.

• Respect and maintain the confidentiality of sensitive business and patient information at all times. Maintain files and work papers consistent with Option Care Health policy and Compliance processes at all times.

• Develop and revise compliance policy and procedures related to auditing and monitoring activities. Support Compliance leadership in risk assessment, work planning and budgeting activities.

• Effectively collaborate on integrated reviews and process assessments with other functions, such as Legal, Internal Audit, Quality & Risk Management, Revenue Cycle Management, Information Security, Human Resources, Operations, etc.

• Manage and partner with external professional services organizations engaged to conduct compliance audits and monitoring activities to support successful completion of such initiatives. Also coordinate with external and internal auditors and internal stakeholders to foster understanding and provide required documentation, correspondence, responses, information or other follow up as needed.

• Develop and maintain relationships with external partners, such as regulatory agencies, industry associations, and legal counsel, to stay informed of emerging compliance trends and best practices.

• Provide ongoing direction, management, coaching and development to Compliance staff and foster a team culture of diversity, inclusion, connectivity and professional growth.

• Stay abreast of changes in healthcare regulations, industry trends, and best practices in compliance analytics, and proactively identify opportunities to enhance compliance processes and systems.

• Supports compliance and privacy integration initiatives with new business models.

Supervisory Responsibilities

Does this position have supervisory responsibilities? Yes

(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

Basic Education and/or Experience Requirements

• Bachelor's degree in healthcare administration, business, finance, statistics, auditing, accounting, or related field; advanced degree preferred. Comparable professional experience will be considered.

• Minimum of 5-7 years of experience in healthcare compliance, audit, analytics or related field, with at least 2-3 years in a leadership or management role overseeing auditing and monitoring activities between third parties and directly managing employees, including hiring, developing, motivating and directing people as they work.

Basic Qualifications

• Demonstrated experience developing, implementing and leading compliance auditing and monitoring programs within a healthcare or similarly regulated industry. High level of proficiency in audit techniques, data analysis, and documentation review, with the ability to conduct thorough and objective audits and investigations.

• Excellent analytical, problem-solving, and critical-thinking skills, with the ability to translate complex data into actionable insights.

• Strong technical proficiency in data analysis, documentation and reporting tools and techniques, such as PowerBI, Tableau, Alteryx, SQL, Python, R, or similar platforms. Strong proficiency in Microsoft Office Suite, including at minimum Excel, Word and PowerPoint.

• In-depth knowledge of healthcare laws and regulations, with specific expertise in compliance requirements related to billing and coding, privacy and security, and fraud, waste and abuse, including but not limited to HIPAA, Anti-Kickback, Stark, Medicare/Medicaid reimbursement. Experience evaluating information to determine compliance with policies, standards, laws, and regulations.

• Excellent project management skills, with the ability to manage multiple projects simultaneously, prioritize tasks, and meet deadlines in a fast-paced environment. Proven experience in managing third party service vendors.

• Experience developing strategic initiatives which align with business goals and budget, drive efficiencies and foster team collaboration. Experience supporting leadership with development of annual workplans, budgets resource planning and reporting.

• Experience participating in ongoing risk assessments to identify potential compliance risks and vulnerabilities within the organization, working collaboratively with cross-functional teams to develop and implementing mitigations.

• Strong communication and interpersonal skills, with the ability to build relationships, influence stakeholders, prepare reports and communicate complex audit findings and recommendations in a clear and concise manner.

• Demonstrated leadership and management capabilities, including the ability to inspire and motivate a high-performing team, foster a culture of integrity, accountability and excellence, and drive results in a dynamic and fast-paced environment through collaboration and teamwork.

• Experience monitoring changes in healthcare laws and regulations, assessing the impact on the organization, and updating compliance programs and policies accordingly.

Travel Requirements: (if required)

Up to 25%

Preferred Qualifications & Interests (PQIs)

• Certified in Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), or similar certification preferred.

• Direct experience in home infusion services, pharmacy and/or nursing compliance programs.

• Direct experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines.

• Formal project management training or certification.

• Proficiency with audit software or other governance, risk and compliance (GRC) tools more broadly

Due to state pay transparency laws, the full range for the position is below:

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $124,025.34-$206,723.61

Benefits:

-401k

-Dental Insurance

-Disability Insurance

-Health Insurance

-Life Insurance

-Paid Time off

-Vision Insurance

Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.

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For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.