Top 8 Investigations manager Jobs in Miami, Fl

Compliance Manager
Alivi —Miami, FL
- $80,000 - $120,000 a year
- Full-time
- OSHA
- 3 years
- Bachelor's degree
- Health savings account
- Health insurance
Quick Apply
17h
Manager, Global Compliance
Univision communications inc —Miami, FL
- Full-time
- Spanish
- English
- Office
- Health insurance
- Dental insurance
Manager, Compliance
Windstar Cruises —Miami, FL
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Research
- Health savings account
- Paid holidays
Quick Apply
Manager, Global Logistics & Compliance
Jazwares, LLC —Plantation, FL
- Email
- 5 years
- ERP systems
- Bachelor's degree
- AD&D insurance
- Disability insurance
Compliance Manager
Quadel Consulting & Training —Miami, FL
- Full-time
- Background check
- Spanish
- Ability to walk for extended periods
Quick Apply
3d
Child Protective Investigator Supervisor
Department of Children and Families —Miami, FL
- From $52,200 a year
- Full-time
- Management
- Military
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
4d
Manager of Safety, Compliance & Risk
ReturnPro —Aventura, FL
- Full-time
- 6 years
- Bachelor's degree
- Continuous improvement
Quick Apply
Civil Eng. - Highway Construction Mngr. - Forensic Investigator
Robson Forensic —Miami Lakes, FL
- Full-time
- Background check
- Construction site
- Bachelor of Science
Quick Apply

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Compliance Manager

Alivi -
Miami, FL

Quick Apply

Job Details

Full-time
$80,000 - $120,000 a year
17 hours ago

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance
Referral program

Qualifications

Teamwork
OSHA
Healthcare Administration
Presentations for conferences or internal meetings
Compliance management
Bachelor's degree
Business Administration

Full Job Description

SUMMARY

The Compliance and Risk Manager is responsible for overseeing the organization’s enterprise-wide compliance and risk management programs, ensuring adherence to federal, state, and health plan requirements, as well as internal policies and industry standards. This role manages the full compliance framework for both clinical and nonclinical benefit programs—including Non-Emergency Medical Transportation (NEMT), Podiatry, Acupuncture, Chiropractic, Therapy, Optometry, Ophthalmology, and additional specialty care services.

The Compliance and Risk Manager conduct internal audits, leads external and health plan audit responses, manages risk assessments, and partners with cross functional teams to strengthen organizational integrity, operational excellence, and regulatory compliance.

DUTIES & RESPONSIBILITIES

Regulatory Compliance

Oversee the organization’s compliance program for all clinical and nonclinical benefits, including NEMT, ancillary care, specialty care, and provider delivered benefits.
Monitor regulatory updates and communicate new or changing compliance requirements across operational departments.
Maintain, update, and enforce compliance policies, procedures, and training programs.
Provide guidance to leadership and business units to ensure alignment with federal, state, Medicaid Managed Care, Medicare Advantage, and commercial health plan obligations.

Audit Oversight – Health Plans & External Audits

Serve as the primary point of contact for all health plan audits, external regulatory audits, accreditation reviews, and delegated oversight audits.
Lead audit preparation, document collection, corrective action plans, and remediation tracking.
Coordinate responses to inquiries from state agencies, plan partners, regulators, and accreditation bodies.
Ensure timely, accurate, and compliant audit submissions across all service lines and business functions.

Risk Management

Conduct enterprise risk assessments and maintain the organization’s risk register.
Identify emerging risks in operations, claims processing, vendor management, and program integrity.
Develop and monitor risk mitigation strategies in collaboration with internal stakeholders.

Investigations & Issue Management

Conduct investigations involving potential policy violations, regulatory risks, fraud/waste/abuse concerns, or operational failures.
Coordinate with Legal, HR, and operational teams as appropriate to ensure proper resolution.
Document all findings, root causes, and remediation outcomes.

Vendor & Third-Party Oversight‑Party Oversight

Oversee compliance obligations for contractors, subcontractors, transportation providers, and clinical networks.
Support credentialing verification, exclusion screening compliance, and risk scoring of third-party entities.
Conduct and oversee delegated vendor audits, corrective action plans, and ongoing monitoring.

Documentation & Reporting

Prepare compliance reports, board level updates, audit summaries, and risk dashboards.
Maintain comprehensive documentation related to audits, investigations, policies, training, and mitigation activities.
Support regulatory submissions as required.

Program Development & Continuous Improvement

Assist in strategic planning and development of enhancements to the compliance and risk programs.
Promote a culture of compliance through training, communication, and proactive risk prevention initiatives.
Identify opportunities to streamline compliance processes and strengthen oversight.
Oversees and provides direct supervision to the Compliance, Fraud, Waste and Abuse (FWA), and Grievances and Appeals team to ensure regulatory adherence and operational effectiveness.

REQUIREMENTS & QUALIFICATIONS

Bachelor’s degree in Business, Healthcare Administration, Risk Management, Legal Studies, or related field required.
Located in Miami, FL, or surrounding areas.
Certified Professional in Healthcare Compliance (CPHC or CHC) preferred.
3–7 years of experience in compliance, risk management, audit, legal, or regulatory affairs.
Strong knowledge of federal and state regulatory frameworks (e.g., HIPAA, CMS, OIG, OSHA).
Exceptional analytical, investigative, and problem‑solving abilities.
High degree of integrity, professionalism, and discretion.
Ability to effectively present information and respond to questions.

Pay: $80,000.00 - $120,000.00 per year

Benefits:

401(k)
Dental insurance
Health insurance
Health savings account
Life insurance
Paid time off
Referral program
Vision insurance

Application Question(s):

Do you have at least 3–5 years of experience in healthcare compliance, risk management, or audit (e.g., Medicaid, Medicare, or health plan environment)?
Have you led or been directly responsible for health plan or regulatory audits, including preparation, response, and corrective action plans (CAPs)?
Which regulatory frameworks do you have hands-on experience with?
Describe a time you identified a compliance risk or audit finding—what actions did you take to resolve it?
Are you currently located in (or able to commute to) Miami, FL, and comfortable working in a highly cross-functional, fast-paced environment?

Experience:

Compliance management: 3 years (Required)

Work Location: In person

Quick Apply

Refine Your Search

investigations manager jobs in miami, fl

Compliance Manager

Manager, Global Compliance

Manager, Compliance

Manager, Global Logistics & Compliance

Compliance Manager

Child Protective Investigator Supervisor

Manager of Safety, Compliance & Risk

Civil Eng. - Highway Construction Mngr. - Forensic Investigator

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