CAREER GUIDE FOR HEALTH CARE COMPLIANCE MANAGER

SOC Code: 11-9199

Pay Band(s): 6      (Salary Structure)

Standard Occupational Description: There is no standard occupational description for the occupation Health Care Compliance Manager as used by the Commonwealth. This occupation is included in the Managers, All Others. This group is comprised of many different types of management occupations with a wide range of characteristics

Commonwealth of Virginia Description: Plan, direct, or coordinate health compliance activities and staff of an organization.

Health Care Compliance Manager positions in the Commonwealth are assigned to the following Roles in the Healthcare Compliance Career Group:

Health Care Compliance Manager

While Health Care Compliance Manager within the Commonwealth are all located within the Healthcare Compliance Career Group, individuals may want to pursue other opportunities within the Commonwealth depending upon individual training, education, knowledge, skills, abilities, and interests.   

Other Career Group(s) that may be of interest are:

General Administration

Program Administration

Nursing/Physician Assistance Services

Physician Services

Counseling Services

 

SKILLS, KNOWLEDGE, ABILITIES AND TASKS

(Technical and Functional Expertise)

Skills
Note: The technical and functional skills listed below are based on general occupational qualifications for Health Care Compliance Manager commonly recognized by most employers.  Typically, you will not be required to have all of the skills listed to be a successful performer.  Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.

  1. Motivating, developing, and directing people as they work, identifying the best people for the job.
  2. Communicating effectively in writing as appropriate for the needs of the audience.
  3. Talking to others to convey information effectively.
  4. Understanding written sentences and paragraphs in work related documents.
  5. Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  6. Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  7. Determining how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
  8. Adjusting actions in relation to others' actions.
  9. Being aware of others' reactions and understanding why they react as they do.
  10. Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.

Knowledge
Note: The technical and functional knowledge statements listed below are based on general occupational qualifications for Health Care Compliance Manager commonly recognized by most employers.  Typically, you will not be required to have all of the knowledge listed to be a successful performer.  Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.

The Knowledge of:

  1. Principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
  2. Business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
  3. Arithmetic and statistics, and their applications.
  4. Structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
  5. Human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders.
  6. Laws, legal codes, court procedures, precedents, government regulations, executive orders, and institutional rules to include federal and state hospital licensure and/or accreditation standards.
  7. Information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.
  8. Plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment.
  9. Chemical composition, structure, and properties of substances and of the chemical processes and transformations that they undergo. This includes uses of chemicals and their interactions, danger signs, production techniques, and disposal methods.
  10. Principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions.

Abilities
Note: The technical and functional abilities listed below are based on general occupational qualifications for Health Care Compliance Manager commonly recognized by most employers.  Typically, you will not be required to have all of the abilities listed to be a successful performer.  Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.

The Ability to:

  1. Read and understand information and ideas presented in writing.
  2. Listen to and understand information and ideas presented through spoken words and sentences.
  3. Communicate information and ideas in speaking so others will understand.
  4. Communicate information and ideas in writing so others will understand.
  5. Apply general rules to specific problems to produce answers that make sense.
  6. Tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
  7. Combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
  8. Concentrate on a task over a period of time without being distracted.
  9. Identify or detect a known pattern (a figure, object, word, or sound) that is hidden in other distracting material.
  10. Manage projects and program objectives.

Tasks
Note:  The following is a list of sample tasks typically performed by Health Care Compliance Manager.  Employees in this occupation will not necessarily perform all of the tasks listed. 

  1. Administer, direct, and review health compliance programs.
  2. Advise management in improving and carrying out policies relating to health care compliance programs in accordance with federal and state regulations.
  3. Analyze statistical data and reports to identify and determine health care compliance issues.
  4. Fulfill all reporting requirements of all-relevant government rules and regulations.
  5. Monitor progress in achieving program goals and objectives and evaluate results.
  6. Represent the organization in formal meetings with outside organizations on matters dealing with health care compliance.
  7. Direct and manage staff in evaluating a variety of treatment programs, standards and medical protocol in medical facilities to ensure quality care to patients.
  8. Ensure high standard of client care by establishing best practice benchmarks.
  9. Plan and organize special seminars and provide training for staff and others on health compliance issues.

INTERESTED?

Like people, occupations have traits or characteristics.  These characteristics give important clues about the nature of the work and work environment, and give you an opportunity to match your own personal interests to a specific occupation.  When you choose a job in an occupation that matches your own interests you have taken an important step in planning a successful and rewarding career.

The occupation of Health Care Compliance Manager has characteristics as described below:

Investigative — Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally.

Conventional — Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.

Enterprising — Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.

Social — Social occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others.

LICENSURE, REGISTRATION, OR CERTIFICATION REQUIREMENTS

Generally this is required for Health Care Compliance Manager positions in state government. The Health Care Compliance Manager supervises health care practitioners. This typically requires licensure as a practicing nurse or another health care profession depending on the programs managed.

Licensing information for nurses and other health care professionals can be found on the Department of Health Professional's web site at http://www.dhp.state.virginia.us/.

Managers with the Commonwealth of Virginia are eligible for the Virginia Certified Public Manager Program offered by the Department of Human Resource Management. Web site is http://www.dpt.state.va.us/training/cpm/cpmhome.htm. This certificate program offers practitioner-oriented course work that builds upon management training programs offered through agencies, colleges, and universities.

Attainment of the Certified Administrative Manager (CAM) designation offered by the Institute of Certified Professional Managers, through work experience and successful completion of examinations, can increase a manager's advancement potential. The Institute of Certified Professional Managers is a certifying organization and offers a management certification program. The Institute is located at James Madison University, Harrisonburg, Virginia.  Web site is http://cob.jmu.edu/icpm. Management Skills is the theme of the program, which emphasizes the teaching and application of real-world, practical skills and techniques over theories, and critical-thinking skills over rote knowledge.

Certification may enhance professional development and career progression.

EDUCATIONAL, TRAINING, AND LEARNING OPPORTUNITIES 

Because of the diversity of health compliance programs managed, the educational backgrounds of the Health Care Compliance Managers may vary considerably. In filling management jobs, employers seek college graduates who have majored in a health care field. The health care areas may be in nursing, counseling, medicine or other clinical fields.

Most employers prefer at least a baccalaureate degree in a health field, clinical work experience and demonstration of progressive leadership responsibilities.

The State Council of Higher Education lists many Virginia educational institutions offering programs in health care fields and management on their web site: http://research.schev.edu/degreeinventory/inventory_

Other training opportunities may be training offered by agencies through the Virginia Center for Public Policy at VCU (www.oppt.org) such as attendance at the various progressive level management courses and institutes for managers and executives (i.e. Virginia Supervisory Institute (VSI), Advanced Management Institute (AMI) and the Virginia Executive Institute (VEI).

COMMONWEALTH COMPETENCIES

Competencies are a set of identified behaviors, knowledge, skills, and abilities that directly and positively impact the success of employees and the organization. Competencies can be observed and measured.  When consistently demonstrated, competencies make employees particularly effective in their work.  Competencies help lay out a road map to career success.  You can use the Commonwealth Competencies to help improve your individual performance by adopting behaviors that make high performing employees successful in their jobs. In this way, you can use the Commonwealth Competencies for your further professional development.

The Commonwealth Competencies are:

  1. Technical and Functional Expertise
  2. Understanding the Business      
  3. Achieving Results
  4. Serving the Customer
  5. Teamwork
  6. Interpersonal and Communication Skills
  7. Leadership and Personal Effectiveness

 The above competencies may be applied to employees throughout the Commonwealth of Virginia.  They can be rank-ordered by agencies and hiring managers to represent the needs of a specific job.  The rank ordering will change depending upon the occupation, an organization's priorities, the actual job requirements, and the supervisor's preferences. 

Career success is both about what you do (applying your technical knowledge, skills, and ability) and how you do it (the consistent behaviors you demonstrate and choose to use) while interacting and communicating with others.  Hopefully, by studying the Commonwealth competencies, identifying your developmental opportunities, and working to refine your own competence, you can take charge of your career!

For additional information about the Commonwealth Competencies go to: http://jobs.state.va.us/cc_planningctr.htm.  For the competencies, we first list the competencies and then define each.  Finally, we list competency indicators; to describe what successful performance looks like. 

COMMONWEALTH CAREER PATH

Career opportunities in the Commonwealth are not limited to moving “up” to the next highest role and pay band, changing positions, or to becoming a supervisor.  That's because most roles describe a broad group of occupationally related positions that perform a range of work that requires increased knowledge and skills.  For that reason, Commonwealth roles describe the career paths within the same or higher-level role for the same or different Career Group.  The broad salary range and the Commonwealth's pay practices provide flexibility in recognizing career development and advancement. (Salary Structure)

For example: Inspector-Medical Facilities

 

PAY BAND

MANAGER ROLES

 

6

Healthcare Compliance Manager I

     
     

Sample Career Path

Health Care Compliance Manager

The Health Care Compliance Manager role provides career tracks for managers who manage and direct licensure inspection programs, health care compliance, and utilization review program operations. The work includes development, implementation, and evaluation of operational goals, objectives, policies, procedures, legislative recommendations, and operating budget.

ADDITIONAL OCCUPATIONAL INFORMATION CAN BE FOUND AT: 

O*NET (Occupational Information Network) 

http://online.onetcenter.org/gen_search_page

Virginia Employment Commission 

http://www.alex.vec.state.va.us/

Career One Stop

  http://www.careeronestop.org/

Virginia Career Resource Network

 http://www.vacrn.net/