Director of Compliance/Government Regulation

Outreach Community Health Centers • Milwaukee, WI

89d

About The Position

The Director of Compliance/Government Regulation provides strategic leadership, oversight, and expert guidance for the Health Center's Compliance and Quality Improvement Programs, encompassing all clinical and administrative departments. This role serves as the designated Compliance Officer for the Health Center and is responsible for the development, implementation, and ongoing management of the organization's Compliance Program. In this capacity, the Director reports directly to the Chief Executive Officer (CEO) and the Board of Directors.

Requirements

• Bachelor's degree required; Master's degree in Healthcare Administration or related field preferred
• Three (3) to five (5) years of experience in compliance and/or grants management
• Experience in a Federally Qualified Health Center (FQHC) setting preferred
• Demonstrated understanding of compliance, risk assessment, and mitigation strategies
• Strong knowledge of federal and state grant regulations, including the Federal Uniform Administrative Requirements for HHS Awards (45 CFR Part 75) and accreditation standards
• Proven ability to manage multiple tasks and priorities while collaborating effectively within a team environment
• Cultural competence and the ability to work effectively with individuals from diverse backgrounds
• Demonstrated initiative and sound professional judgment, with the ability to engage staff, clinicians, administrators, and board members in supporting a strong Culture of Compliance
• Ability to work independently, manage time efficiently, and adapt to changing priorities
• Excellent written and verbal communication skills
• Exceptional organizational skills and strong attention to detail
• Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint

Responsibilities

• Oversee, monitor, and continuously improve compliance with federal, state, and county regulations across all health center operations, including billing and grant-funded programs.
• Serve as a key member of the Health Center's Leadership Team, contributing to strategic planning and operational oversight.
• Maintain comprehensive and up-to-date knowledge of federal and state regulations governing Federally Qualified Health Centers (FQHCs).
• Develop and implement an annual compliance work plan that identifies and prioritizes regulatory items, high-risk areas, and potential vulnerabilities, with strategies for improvement.
• Conduct periodic internal audits to assess regulatory compliance and support the development of best practice workflows that include effective checks and balances to mitigate error or fraud.
• Assist in the investigation of potential incidents related to healthcare coding, billing, reimbursement, fraud, abuse, conflicts of interest, and breaches of privacy, confidentiality, or security.
• Develop and maintain policies and procedures addressing standards of conduct, regulatory compliance, and the safe reporting of suspected fraud or misconduct without fear of retaliation.
• Draft and revise policies and procedures in response to evolving regulatory requirements, as needed.
• Lead all aspects of the HRSA Operational Site Visit, including ongoing preparation, coordination of pre-visit logistics, on-site visit activities, and post-visit follow-up.
• Analyze findings from internal and external audits and site visits to assess compliance and recommend corrective actions when necessary.
• Establish and manage a robust reporting system for employees to voice concerns and seek guidance; ensure enforcement mechanisms and disciplinary processes are in place for compliance violations.
• Maintain thorough documentation of all compliance efforts, corrective actions, and enforcement activities.
• Conduct, supervise, or coordinate investigations of alleged compliance violations, determining root causes and implementing necessary corrective actions.
• Collaborate closely with the Grants Director/Manager, Program Managers, and Leadership Team to ensure regulatory compliance across all federal and state grants, including HRSA 330 and Ryan White HIV/AIDS Program grants.
• Partner with the Information Technology team to support compliance with meaningful use standards and HITECH/HIPAA requirements.
• Provide training and technical assistance to staff on compliance policies, procedures, and applicable regulations.
• Perform other duties as assigned to support the mission and compliance objectives of the health center.

What This Job Offers

• Career Level: Senior
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree
• Number of Employees: 51-100 employees