Senior Director, Compliance Officer
RemoteUnited States
Job Summary
Develop and oversee a comprehensive compliance program aligned with federal and state healthcare regulations, including CMS, HIPAA, and state-specific managed care requirements. Lead internal audits, risk assessments, and the development of policies to mitigate regulatory risk and foster a culture of ethics. Serve as the primary liaison with regulatory agencies and health plan partners, while chairing the Compliance Committee and related sub-committees. Investigate compliance issues, resolve allegations of misconduct, and prepare reports for the General Counsel and Board of Directors. Manage the department's budget and coordinate oversight of affiliated contractors. Stay current with evolving regulations to advise leadership on necessary changes.
Required Qualifications
- Bachelor's degree
- Minimum of 8 years of experience in healthcare compliance
- Deep understanding of regulatory frameworks including CMS, HIPAA, and state Medicaid/Medicare regulations
- Experience working with delegated services and provider networks
- Proven ability to lead cross-functional teams and influence organizational change
- Exceptional communication and presentation skills
- Strong analytical and problem-solving skills
Desired Qualifications
- JD, MBA, or Master's in Healthcare Administration
- Certification in Healthcare Compliance (CHC) or similar credential
- Experience with compliance technology platforms and data analytics
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