Director of Compliance (Doral)

Company Description

Solis Health Plans is a Medicare Advantage plan committed to meeting the needs of our members, providers, and partners. We pride ourselves on understanding the communities we serve and offering personalized, hands-on service. Solis is distinguished by our dedication to quality, efficiency, and collaboration. Our mission is to provide benefits and services that make a real difference in our members' lives. Welcome to healthcare that makes a difference. Welcome to Solis.

Role Description

This is a full-time, on-site role for a Director of Compliance located in Doral, FL. The Director of Compliance is responsible for overseeing and managing all aspects of the organizations Compliance Program to ensure adherence to Centers for Medicare & Medicaid Services (CMS) regulations, state and federal laws, and internal policies. This leader will play a key role in maintaining an effective compliance culture across the organization, providing guidance and oversight to ensure Solis Medicare Advantages operations remain compliant, ethical, and aligned with regulatory expectations.

Key Responsibilities

Regulatory Compliance & Oversight

• Develop, implement, and maintain the organizations Compliance Program consistent with CMS requirements for Medicare Advantage (MA) and Part D plans.
• Monitor ongoing compliance with applicable federal and state laws, including CMS rules, HIPAA, and other healthcare regulations.
• Serve as the primary point of contact for CMS, OIG, AHCA, and other regulatory agencies during audits, data validation reviews, and compliance inquiries.
• Ensure accurate and timely submission of CMS required reporting, including compliance attestations and annual training certifications.

Compliance Program Administration

Collaboration & Guidance

Reporting & Documentation

Qualifications

Education :

Experience :

Skills & Competencies :

Work Environment

This is a full-time, onsite leadership role requiring collaboration with internal departments and external partners. Occasional travel may be required for audits, training, or regulatory meetings.