Hospice Compliance Manager - External Audit

Our people are the difference.

Transitions Care is a leading hospice organization that has changed the hospice experience for patients, families, and team members. Imagine a healthcare company that provides 24/7 access to services in 

the comfort of the patient's home - providing the physical, emotional, and spiritual support that allows a patient to focus on living.

At Transitions, you don't have to imagine! Apply now to join our team and experience the Transitions difference!

As the Compliance Manager – External Audit at Transitions Care you will be responsible for leading and managing the organization’s external audit and regulatory response function for Transitions. This role oversees the end-to-end coordination, execution, and monitoring of all external audit requests, including but not limited to Targeted Probe and Educate (TPE) audits, Additional Documentation Requests (ADRs), Supplemental Medical Review Contractor (SMRC) reviews, Unified Program Integrity Contractor (UPIC) audits, and other payer or regulatory inquiries.

The Compliance Manager serves as the primary liaison between external auditors and internal stakeholders, working closely with Operations, Clinical, Compliance, Finance, and Revenue Cycle Management (RCM) teams to ensure accurate, timely, and compliant responses.

In addition, this role supports the broader Compliance Program by contributing to initiatives aligned with the Seven Elements of an Effective Compliance Program, including investigations, privacy initiatives, licensure activities, compliance education, and ongoing program improvement efforts.

This is a hybrid position, combining in-office and remote work.  

Major Responsibilities

• Serve as the centralized owner for all external audit and regulatory requests, ensuring consistent, organized, and compliant responses.
• Triage, coordinate, and provide project management for all incoming audit requests across the organization.
• Establish and maintain secure virtual repositories for the exchange and storage of sensitive audit documentation.
• Track, monitor, and report on audit progress, deadlines, and outcomes to ensure all regulatory timelines are met.
• Review clinical and operational documentation for accuracy, completeness, and regulatory compliance prior to submission.
• Identify, document, and communicate potential deficiencies; partner with Clinical, Operations, and other teams to remediate gaps.
• Oversee and ensure all appeals are evaluated and pursued in a timely, thorough, and methodical manner.
• Reporting & Stakeholder Communication
• Provide clear, concise, and timely status updates and summary reports to executive leadership and key stakeholders regarding open audits, findings, risks, and outcomes.
• Educate administrators, Directors of Nursing (DONs), and other operational leaders on audit processes, expectations, and best practices.
• Act as a subject matter resource for external audit requirements, documentation standards, and regulatory expectations.
• Support Compliance Department activities related to: Internal investigations, Privacy and confidentiality initiatives, Licensure renewals and applications, Compliance education and training and other initiatives supporting the Seven Elements of an Effective Compliance Program
• Assist in identifying systemic risks, trends, and improvement opportunities arising from audit activity.
• Promote compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures. 
• Conduct all business activities in a professional and ethical manner.  
• Meet or exceed delivery of Company Service Standards in a consistent fashion. Adherence to the Transitions Hospice Code of Conduct.  
• Interact with all staff in a positive and motivated fashion supporting the company’s mission and service standards. 

Benefits We Offer

• Competitive pay
• Medical / Dental / Vision Insurance plans
• Life Insurance
• 401(k) matching
• Company Equipment
• Paid Time Off

Education and Experience

• Minimum age requirement of 18.  
• Licensed Practical Nurse (LPN), Registered Nurse (RN), or Licensed Social Worker.
• Minimum of 5 years of experience in a hospice setting.
• Strong working knowledge of hospice clinical documentation requirements.
• Demonstrated knowledge of Hospice Conditions of Participation (CoPs).
• Proficient in navigating Homecare Homebase (HCHB).
• Strong project management, organizational, and prioritization skills.
• Proven ability to work independently with minimal supervision.
• Effective cross-functional communication and collaboration skills.
• High attention to detail and ability to manage sensitive, confidential information.
• Experience with hospice licensure requirements at the state and federal level preferred.
• Certified in Healthcare Compliance (CHC) or equivalent professional certification preferred.
• Understanding of Hospice philosophy, principles of death/dying, and eligibility criteria.  
• Compliance with accepted professional standards and practices.