Director of Compliance

Smile America Partners•Phoenix, AZ

10d•Hybrid

About The Position

The Director of Compliance is the operational leader of Smile America Partners’ Compliance Program, working under the direction of the Chief Compliance Officer (CCO). The Director translates the CCO’s strategy and priorities into day-to-day operations, including risk assessment, monitoring and auditing, investigations, corrective actions, policy administration, education, regulatory readiness, clinical compliance oversight, and assigned enterprise risk and corporate regulatory administration. The position is based in the Phoenix, Arizona office and is hybrid remote/office-based. The Director coordinates the annual compliance work plan, maintains documentation of program activities, and works across Compliance, Clinical, Operations, Revenue Cycle, Human Resources, Legal, Finance, Information Technology, and other functions. The role oversees compliance reviews and investigations, tracks corrective actions, supports policies and training, monitors regulatory developments, and helps prepare for external reviews. It also provides leadership to the Clinical Compliance Manager and coordinates corporate filings, licensing, insurance and risk-management administration, enterprise risk controls, fleet compliance, and assigned intellectual property administration. The Director prepares reports and trend analyses for the CCO, supports reporting to executive leadership, the Compliance Committee, and the Board or an appropriate Board committee, and supervises assigned Compliance staff. The Director serves as the CCO’s operational delegate for routine compliance and assigned enterprise risk matters; significant compliance decisions, enterprise risk determinations, and Board-level matters remain under the CCO’s authority.

Requirements

Bachelor’s degree in healthcare administration, business, legal studies, compliance, a clinical discipline, or a related field.
Progressive experience in healthcare compliance, regulatory compliance, auditing, investigations, revenue cycle compliance, enterprise risk, corporate regulatory administration, or a related field.
Demonstrated knowledge of healthcare compliance program principles and applicable federal and state healthcare regulatory requirements.
Experience managing compliance projects, investigations, audits, corrective actions, regulatory requirements, and cross-functional initiatives.
Strong knowledge of effective healthcare compliance program practices and risk-based compliance oversight.
Ability to independently analyze complex regulatory, operational, clinical, and billing issues and clearly communicate findings.
Strong investigation, auditing, documentation, project management, and problem-solving skills.
Sound judgment and ability to recognize matters requiring prompt escalation to the CCO or Legal Counsel.
Ability to build effective working relationships while maintaining the independence and objectivity required of the Compliance function.
Strong written and verbal communication skills, including the ability to communicate with executives, clinicians, operational leaders, and staff.
High degree of integrity, discretion, professionalism, and commitment to confidentiality and non-retaliation principles.

Nice To Haves

Advanced degree preferred.
Prior supervisory or leadership experience preferred.
Certified in Healthcare Compliance (CHC) strongly preferred.
Additional relevant credentials such as CHPC, CHRC, CPC, CCS, CPA, CIA, or similar certification are beneficial, depending on experience and responsibilities.

Responsibilities

Manage the day-to-day operation and administration of the Compliance Program in alignment with the CCO’s direction and priorities.
Coordinate implementation of the annual compliance work plan and track initiatives, deliverables, and corrective actions.
Promote communication and coordination among Compliance and relevant clinical, operational, business, and support functions.
Maintain documentation demonstrating compliance program activities and effectiveness.
Support periodic compliance risk assessments and identify emerging risks from regulatory developments, audit findings, hotline activity, investigations, and operational trends.
Assist the CCO in developing, implementing, and monitoring the annual compliance work plan; recommend risk-based monitoring, auditing, education, and corrective actions.
Oversee routine compliance monitoring and auditing, including clinical, coding, billing, documentation, and operational reviews.
Coordinate audit methodology, sampling, documentation, findings, management responses, and follow-up; identify trends and escalate significant findings to the CCO.
Track corrective action plans and validate their completion and effectiveness when appropriate.
Manage or support investigations into suspected violations of law, regulation, policy, billing requirements, or standards of conduct; ensure investigations are objective, timely, documented, and escalated appropriately.
Partner with the CCO, outside legal counsel, the Professional Employment Organization, Human Resources, operational and clinical leadership, and other stakeholders as appropriate.
Coordinate corrective and preventive actions arising from investigations, audits, disclosures, complaints, and regulatory findings; immediately escalate significant legal, regulatory, patient safety, financial, retaliation, or False Claims Act concerns to the CCO.
Coordinate development, review, implementation, and maintenance of compliance policies and procedures; oversee or support general and risk-targeted compliance education and training.
Monitor relevant federal and state regulatory developments and help operational leaders evaluate implementation requirements.
Support preparation for payer, governmental, accreditation, and other external compliance reviews.
Provide leadership and oversight to the Clinical Compliance Manager and clinical compliance activities.
Coordinate monitoring of documentation, coding, billing, medical necessity, clinical protocols, and other identified clinical compliance risks; partner with clinical leadership on guidance and education.
Ensure clinical compliance findings and trends are communicated, remediated, and escalated appropriately.
Coordinate corporate regulatory administration, including annual legal entity filings and reports, business licenses, permits, mobile permits, and state or local registration requirements.
Coordinate compliance and regulatory activities for entry into new states and markets, including tracking required licenses, permits, registrations, and related requirements.
Coordinate corporate insurance and risk-management administration, including certificates of insurance, annual renewals, and communication with brokers, carriers, Legal, Clinical, IT, Operations, and other stakeholders.
Maintain or coordinate the dentist master roster and other organizational or provider records supporting insurance, licensing, credentialing, and regulatory requirements.
Coordinate enterprise risk-control activities, including periodic reviews, IT risk-control meetings, control changes, and related policy updates.
Coordinate fleet and risk compliance activities, including claims administration and follow-up.
Coordinate with departments on identified risks, controls, operational changes, and policies, escalating material enterprise risks to the CCO.
Coordinate routine intellectual property administration and maintenance with outside counsel, as assigned by the CCO.
Coordinate maintenance of required in-state corporate addresses and related renewals or administrative requirements.
Prepare compliance reports, dashboards, metrics, trend analyses, and other materials for the CCO; support CCO reporting to executive leadership, the Compliance Committee, and the Board or appropriate Board committee.
Supervise, coach, and develop assigned Compliance staff and establish clear performance expectations.
Serve as the CCO’s operational delegate for routine compliance and assigned enterprise risk matters while recognizing the CCO’s authority over significant decisions and Board-level matters.