Program Manager – Compliance (Healthcare)
ExpleoAbout the role
Overview
Location: Hybrid (Minneapolis MN. – up to 3 days onsite per week)Employment Type: Full-Time
Are you a seasoned healthcare compliance professional ready to lead high-impact initiatives? Trissential is hiring a Program Manager – Compliance to join our client’s team, where you’ll play a critical role in advancing regulatory excellence across hospital and affiliated care settings.
This is a unique opportunity to shape compliance strategy, lead accreditation success, and influence patient safety and quality outcomes at scale.
What’s in It for You?
- Lead Meaningful Change - Drive compliance strategy and ensure continuous readiness for major regulatory bodies such as The Joint Commission (TJC) and CMS.
- High-Impact Leadership - Partner with senior leaders and cross-functional teams to strengthen patient safety, operational excellence, and regulatory performance.
- Enterprise-Level Visibility - Present insights, risks, and recommendations directly to executive leadership.
- Innovation & Continuous Improvement - Apply Lean, Six Sigma, and PDSA methodologies to optimize compliance programs and outcomes.
- Collaborative Culture- Work alongside experienced healthcare professionals committed to high reliability and continuous improvement.
Your Role & Responsibilities
- Lead and support accreditation processes, including The Joint Commission (TJC) surveys and regulatory reviews
- Serve as the organization’s subject matter expert (SME) for TJC standards, CMS Conditions of Participation, and related regulatory frameworks
- Drive continuous regulatory readiness through proactive risk identification, mitigation strategies, and compliance monitoring programs
- Lead end-to-end survey readiness and execution, directing all activities to ensure successful accreditation outcomes
- Conduct gap assessments, assign risk levels/criticality, and implement corrective action plans
- Establish and manage a regulatory surveillance function to track, interpret, and operationalize changes from CMS, MDH, and other governing bodies
- Collaborate with clinical, operational, and administrative stakeholders across hospital and affiliated services (e.g., homecare, hospice, infusion, and specialty programs)
- Support policy development, alignment, and staff education/training to ensure compliance with evolving regulations
- Facilitate and lead on-site surveys, internal audits, and readiness reviews
- Analyze performance and compliance data to identify trends and drive decision-making
- Utilize Lean, Six Sigma, or PDSA methodologies to improve processes and regulatory outcomes
- Develop dashboards, tracking tools, and executive-level presentations
Skills & Experience You Should Possess
- 5–7 years of experience in healthcare compliance, accreditation, quality, or program management
- 2+ years of experience leading or supporting TJC accreditation processes, regulatory surveys, or healthcare compliance programs
- Strong expertise in TJC, CMS (Conditions of Participation), MDH, and related regulatory requirements
- Proven ability to lead accreditation efforts and regulatory surveys
- Experience conducting risk assessments, compliance gap analyses, and corrective action planning
- Knowledge of OSHA, building, and fire safety codes
- Demonstrated success leading cross-functional, large-scale compliance or quality initiatives
- Strong analytical skills with the ability to translate complex data into actionable insights
- Experience building tracking tools, dashboards, and reporting frameworks to monitor compliance performance
- Exceptional communication and influencing skills across all organizational levels
- Ability to operate independently and partner effectively with multidisciplinary teams
Bonus Points If You Have:
- Experience working across multiple healthcare entities or care settings
- Lean or Six Sigma certification (Green Belt or Black Belt)
- CPHQ, ASQ, or Certified Joint Commission Professional (CJCP) certification
- Experience with electronic medical records (EMR) systems
- Background in statistical analysis or healthcare data interpretation
Education & Certifications You Need:
- Bachelor’s degree in Nursing, Healthcare Administration, Quality Management, or related field
- Master’s degree in healthca
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