Vice President of Compliance

Job Description

Job Summary

The Vice President of Compliance will lead the development and implementation of a comprehensive compliance and monitoring program across the enterprise. This role is responsible for building the compliance function, ensuring adherence to applicable laws, regulations, and internal policies and aligning the program to the seven elements of an effective healthcare compliance program.

The Vice President of Compliance will serve as a trusted advisor and strategic partner to the executive leadership team, and operational leaders. They will not only identify areas of compliance risk but also actively collaborate with stakeholders to implement practical and sustainable solutions. Experience in private equity-backed healthcare organizations and a strong track record of credibility, change management, and risk mitigation are required.

The successful candidate will be responsible for the following

• Build and lead the centralized compliance function, including internal frameworks, policies, monitoring systems, and training programs, ensuring adherence to the seven elements.
• Conduct annual risk assessments across all business lines to identify potential compliance issues and gaps.
• Develop and report quarterly on the Compliance Workplan and Internal Audit Workplan.
• Design and implement effective monitoring tools to ensure ongoing compliance with healthcare laws and regulations including HIPAA, Stark Law, Anti-Kickback Statute, and CMS requirements and payor contract compliance
• Collaborate with executive and operational leaders to manage change and embed a culture of compliance throughout the organization.
• Develop and manage the compliance reporting structure, including regular updates to senior leadership and the Board of Directors through the Compliance Committee.
• Provide strategic guidance on business initiatives, including new services, and acquisitions ensure regulatory compliance from inception through execution.
• Investigate reports of potential compliance violations, oversee internal investigations, and ensure appropriate corrective actions are taken.
• Develop and Lead compliance training programs across the organization to promote awareness and accountability at all levels.
• Liaise with external counsel and regulatory agencies as needed, including chart review, preparing for audits, surveys, or government inquiries.
• Stay informed of regulatory developments and industry trends and proactively adjust the company compliance programs to maintain alignment with best practices and evolving standards.
• Oversee the Internal Audit efforts of the organization.
• Coordinate with Operations leaders to ensure timely responses to external audit and regulatory requests.
• Work collaboratively with the IT leader on Privacy and Security efforts.
• Act as the main point of contact for breach notifications / investigations and ensures appropriate and annual reporting to the OCR.
• Conduct investigations on an as needed basis and ensure the compliance log is maintained.
• Develop and implement the code of conduct in collaboration with the head of HR.
• Develop and Oversee the Compliance Matters database.
• Develop tools and solutions to ensure compliance with state, federal, and regulatory requirements such as OSHA and the Better Business Bureau.
• Partner with leadership to ensure Business Associate Agreements are obtained and maintained within an appropriate tracking mechanism.
• Assist with review of new payer contracts to determine any additional compliance requirements.
• Ensures appropriate vendor or internal processes to appropriately hire / screen new and existing staff for exclusions.

Qualifications

Optional but desirable qualification