Job Description

Job Posting: Director of Compliance

Location: Full-time

Schedule: Mon–Thu 9:00–5:00, Fri 9:00–1:00

Reports to: Senior Chief Compliance Officer

About the Role

We are seeking an experienced Director of Compliance to lead our organization’s compliance program and provider-relations operations. This role oversees regulatory adherence, internal and external audits, contracting, and communication with state and federal agencies. The ideal candidate is detail-oriented, highly organized, and experienced in healthcare compliance.

Key Responsibilities

• Oversee contracting and credentialing with MLTCs/HMOs
• Lead rate negotiations and resolve payment or rate discrepancies
• Manage internal and external audits (OMIG, DOH, Joint Commission, payers)
• Maintain and update company policies and interpret regulatory updates (DALs)
• Conduct regular compliance monitoring: timesheet reviews, file audits, exclusion checks, conflict checks, etc.
• Prepare materials for Board and Compliance Committee meetings
• Lead investigations related to complaints, grievances, or sensitive incidents
• Ensure proper documentation and regulatory reporting
• Serve as Corporate Compliance Officer and HRA Complaint Coordinator

Required Qualifications

• Significant experience in compliance, auditing, or regulatory oversight
• Strong skills in analysis, critical thinking, and interpreting healthcare regulations
• Experience managing audits, corrective action plans, and compliance reviews
• Ability to translate complex rules into clear operational guidance
• Experience conducting investigations and handling confidential matters

Preferred Qualifications

• Knowledge of OMIG, DOH, HRA, Medicaid, and Joint Commission requirements
• Experience with MLTC/HMO contracting
• Familiarity with HHAeXchange and Smartsheet
• Background in policy development and compliance reporting