Director, Compliance

Author Health, LLC

10d • Remote

About The Position

This pivotal role involves overseeing all aspects of our company's compliance program, ensuring we meet regulatory requirements and maintain the highest standards of integrity. The ideal candidate will be a proactive problem-solver with a strong background in healthcare compliance, particularly with HIPAA and other relevant regulations. You'll be the primary point of contact for all compliance-related matters, working closely with various teams and leadership to build a culture of compliance. We're a fast-growing telehealth startup looking for a dedicated and experienced Director, Compliance. This pivotal role involves overseeing all aspects of our company's compliance program, ensuring we meet regulatory requirements and maintain the highest standards of integrity. The ideal candidate will be a proactive problem-solver with a strong background in healthcare compliance, particularly with HIPAA and other relevant regulations. You'll be the primary point of contact for all compliance-related matters, working closely with various teams and leadership to build a culture of compliance.

Requirements

• Strong regulatory expertise across CMS programs, HIPAA/privacy rules, state managed care requirements, and healthcare fraud/waste/abuse regulations.
• Experience scaling compliance functions in a startup or fast-growth healthcare environment.
• Operational fluency in clinical, care management, and data exchange processes common in value-based care organizations.
• Exceptional communication and influencing skills with the ability to work cross-functionally and advise both executive leadership and front-line teams.
• High analytical capability with proficiency in interpreting regulatory text, designing controls, and reviewing data sets for compliance anomalies.
• Strong leadership and team-building skills with experience developing compliance staff and fostering an ethical organizational culture.
• Detail-oriented and process-driven, with strong project management skills and the ability to execute in a dynamic, ambiguous environment.
• Proficiency in Governance, Risk, and Compliance (GRC) systems and tools, with proven experience in optimizing and integrating GRC processes to drive efficiency, automation, and data-driven insights.
• Proven experience managing complex internal and external audits, including regulatory examinations (e.g., CMS, state agencies) and payor audits
• Five (5) to seven (7) years of work experience in a compliance function, preferably with a Mental Health provider.
• 5-7 years of experience with health care regulatory agencies in development of compliance programs.
• Experience working with Medicare, Medicare Advantage, and Medicaid.
• 5+ years’ experience with overseeing implementation of payer contracts.
• Bachelor’s degree in related field or equivalent experience; advanced degree or certifications (e.g., JD, CHC, CHPC, CPC, RHIA) preferred.

Responsibilities

• Policy & Procedure Management: Develop, implement, and maintain compliance policies, procedures, and training programs, ensuring they are current and effective.
• Incident & Violation Management: Lead the process for investigating and documenting HIPAA violations, handling all associated forms and reporting. Manage all incident reporting, from initial intake to resolution.
• Regulatory & Audit Oversight: Oversee and manage payor audits, OIG and SAM exclusion reporting for external vendors, and other regulatory filings.
• Leadership & Collaboration: Lead the internal Compliance Committee and serve as the main point of contact for compliance-related inquiries from all departments. Work cross-functionally and collaborate with external counsel, IT, and other teams.
• Risk Management: Maintain and manage the organizations risk register ensuring that all risks are captured, given a priority, and ultimately resolved within required timeframes.
• NCQA Certification: Lead the NCQA certification process to bring licensing and credentialing in-house, ensuring all requirements are met and documented.
• Vendor Management: Partner with the IT department on the Vendor Management Process, focusing on compliance and security. Appropriately identify risks to the business in vendor contracts and communicate / advise senior leadership on decision-making.
• Documentation & Reporting: Maintain and update the compliance Confluence page, and prepare compliance data and reports for presentation to the Board of Directors.
• Legal Processes: Handle Power of Attorneys and medical releases, and provide guidance on related questions.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 51-100 employees