Director, Compliance Operations

Description

Now is the time to join PDS Health. You will have opportunities to learn new skills from our team of experienced professionals. If you’re ready to take your career to the next level and gain valuable experience, apply today!

Overview

The Director of Compliance and Ethics will help lead the enterprise compliance program as the organization looks to transform its services platform into the nation’s leading medical/dental integrated healthcare company. The Director will work to transform the compliance program to a more data-driven, proactive function that can successfully measure and drive improvement across multiple risk areas.

Responsibilities

• Program Development & Implementation:
  • Develops, implements, and maintains a comprehensive compliance program that encompasses medical, dental, and administrative operations.
  • Creates and updates preventive controls, including policies and training, to ensure compliance with all applicable laws, regulations, and industry best practices, including Anti-Kickback Statute, False Claims Act, HIPAA, Stark Law, and other relevant regulations.
• Risk Assessment & Mitigation:
  • Conducts annual risk assessments to identify potential areas of compliance gaps and risk.
  • Develops and implement mitigation strategies to address identified risks.
  • Monitors changes in laws and regulations and ensure the company adapts its compliance program accordingly.
• Monitoring & Auditing:
  • Develops and implements a monitoring program that is measurable and data-driven, promoting compliance with key regulatory policies and procedures spanning over a thousand provider offices.
  • Establishes and enhances strong detective controls that will not unduly burden our ability to provide quality care to patients.
• Investigation & Remediation:
  • Investigates potential compliance violations, including employee complaints, regulator inquiries, and audit findings.
  • Develops and implements corrective action plans to address identified violations.
  • Tracks and monitors corrective actions to ensure they are effective in preventing future violations.
• Leadership & Collaboration:
  • Serves as a key advisor to the executive leadership team on compliance matters.
  • Collaborates with other departments, including legal, clinical, finance, human resources, and operations, to ensure compliance is integrated into all aspects of the organization.
  • Represents the company in interactions with regulatory agencies.
  • Other duties and responsibilities as assigned.

Qualifications

• Bachelor’s degree required. Minimum of 10+ years of professional experience or 8+ years of experience with an advanced degree.

Preferred

• Advanced degree such as a Master’s degree in a relevant field (such as healthcare compliance, public health, or healthcare administration) or Juris Doctor (JD).

Knowledge/Skills/Abilities

• Deep understanding of regulations applying across healthcare landscape, particularly medical primary care and/or dental provider space.
• Expertise in designing, implementing, and managing effective compliance programs (e.g., risk assessments, policy development, training, monitoring, auditing, reporting).
• Knowledge of Enterprise Risk Management methodologies and how to identify, assess, mitigate, and monitor compliance risks.
• Understanding of the organization’s business model supporting professional provider practices across dozens of states and the compliance challenges inherent in the model.
• Familiarity with compliance management software, GRC platforms, and data analytics tools used for monitoring and reporting.
• Skill in identifying root causes of compliance issues and developing effective solutions.
• Excellent written and verbal communication skills to effectively communicate complex compliance topics to a diverse audience of employees and medical/dental professionals.
• Ability to identify risk trends and generate meaningful reports for management and executive team illustrating risk and opportunities for improvement.
• Skill in drafting, implementing, and maintaining comprehensive compliance policies and procedures that are practical and enforceable.
• Proficiency in building strong relationships with internal stakeholders (Legal, HR, IT, Operations, Finance) and external parties (regulators and strategic partners).
• The highest level of personal and professional integrity, serving as a role model for ethical conduct.
• Ability to see the “big picture” and align compliance strategies with organizational goals.
• Proactive mindset to identify and mitigate compliance issues before they escalate.
• Capacity to adapt to changing regulatory environments and organizational priorities.
• Meticulousness in reviewing documents, policies, regulations, and data to ensure accuracy and completeness.

Benefits

• Medical, dental, and vision insurance
• Paid time off
• Tuition Reimbursement
• 401K
• Paid time to volunteer in your local community

PDS Health is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.

Salary Information

$150,000.00-$194,000.00 / Annually

Read Full Description