About The Position

US Career Partners is pleased to recruit for this compelling opportunity with a mission-driven healthcare organization delivering Health-Related Social Needs (HRSN) services to New York Medicaid members in Florida. This includes screening, navigation, care management, and meal delivery under the Social Care Network (SCN) initiative — in close partnership with Managed Care Organizations and community partners across the state. This is a rare opportunity to step into a high-visibility compliance leadership role at the ground floor of a growing, purpose-driven program — with direct access to senior leadership and legal, and the mandate to build something meaningful from the ground up. Build Something That Matters. This is not a maintenance role — it is a build role. The incoming Director will have the opportunity to design, launch, and lead a full compliance infrastructure for a program that directly serves vulnerable Medicaid populations. The impact is real, the work is substantive, and the mission is genuine. Direct Access and Influence. Reporting to General Counsel and Compliance Leadership, this position carries real organizational weight. You will be a trusted partner to senior leadership, legal, operations, finance, and IT — with the cross-functional influence to shape how compliance is embedded across the entire organization. Competitive Compensation and Growth. This position offers competitive pay commensurate with experience, within an organization that is growing rapidly and values the professionals who help build it right. This organization delivers HRSN services — including screening, navigation, care management, and meal delivery — to New York Medicaid members under the SCN initiative. The team works in close collaboration with MCOs and community partners to address the social determinants of health for some of the most vulnerable populations in the state. The Director of Compliance will be responsible for building and leading the organization's SCN/HRSN compliance program from the ground up. This is a hands-on leadership role requiring a seasoned healthcare compliance professional with deep Medicaid expertise, strong regulatory fluency, and the ability to translate complex requirements into clear, actionable policies and practices across a diverse set of internal and external stakeholders. The role is based in or Miami FL or Sunrise FL, with regular travel to New York required.

Requirements

  • Bachelor's degree required
  • Minimum of five years of healthcare compliance experience with a meaningful focus on Medicaid
  • Demonstrated track record of building compliance programs, conducting audits, and implementing corrective action plans
  • Strong working knowledge of Medicaid billing and eligibility requirements, fraud/waste/abuse frameworks, and HIPAA
  • Proven ability to translate complex regulatory requirements into practical, accessible guidance for diverse stakeholders
  • Strong analytical capabilities and exceptional communication and cross-functional influence skills

Nice To Haves

  • JD, MHA, MPH, or MBA strongly preferred
  • CHC, CCEP, or CHPC certification a plus
  • Experience with New York Medicaid, HCBS, behavioral health, or social determinants of health programs
  • Auditing background in screening, navigation, or care coordination services
  • Prior exposure to 1115 waivers or Medicaid demonstration programs

Responsibilities

  • Build and lead the end-to-end SCN/HRSN compliance program, establishing policies, controls, and infrastructure
  • Conduct audits of billing, documentation, eligibility, and claims accuracy to ensure ongoing regulatory adherence
  • Ensure data privacy and security compliance for all member and referral data in accordance with applicable requirements
  • Perform risk assessments spanning fraud, waste and abuse, eligibility verification, and contractual obligations
  • Oversee compliance across Lead Entity and MCO partnerships, ensuring alignment with applicable standards
  • Design and deliver compliance training for internal teams and external partners
  • Monitor evolving Medicaid and 1115 waiver regulations and update internal policies accordingly
  • Manage complaint and incident resolution processes and ensure timely, accurate reporting
  • Partner cross-functionally with operations, IT, finance, and legal to embed compliance across the organization
  • Support audit readiness and serve as the primary point of contact for state and MCO compliance inquiries

Benefits

  • Competitive compensation commensurate with experience
  • Direct access to senior leadership and General Counsel
  • The opportunity to build and lead compliance infrastructure for a high-impact, mission-driven program
  • Range of benefits
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