Director of Compliance

PRIORITY AMBULANCE LLC•Knoxville, TN

22h•Onsite

About The Position

The Director of Compliance is responsible for overseeing the EMS regulatory compliance of the organization. The Director of Compliance is responsible for keeping up to date with changes in the industry to ensure the organization is adhering to regulations, laws, and guidelines for governmental entities. The Director of Compliance monitors provider contract compliance, accuracy of billing, and appropriate payments. The Director of Compliance assists the CCO with directing corporate efforts to detect, investigate, and prevent fraudulent or abusive acts and to provide remediation or discipline if such acts are identified. The Director of Compliance will create reports for the CCO showing where there may be gaps in the organization’s compliance and suggest changes or new procedures for employees to follow. This is an Exempt/Salaried position.

Requirements

Certified Compliance Officer or ability to obtain in 6 months.
Ambulance billing experience required.
Must have the ability to function as a leader evaluating, coaching, training, and directing billing and operational staff.
History of effective management in the EMS industry with emphasis on RCM and / or RCM compliance.
7–10+ years of progressive compliance, healthcare, or EMS experience
Experience in multi-state operations is strongly preferred

Nice To Haves

Bachelor’s degree in healthcare administration, Business, Human Resources, or related field preferred
Strong knowledge of EMS regulatory requirements and accreditation standards.
Proven ability to build and scale compliance programs across multi-site operations.
Strong audit, investigation, and risk assessment capabilities.
Ability to translate complex regulatory requirements into operationally practical solutions.
Executive-level communication skills with the ability to influence across all levels of the organization.
High level of discretion, integrity, and sound judgment.

Responsibilities

Leading the development, execution, and oversight of an effective compliance audit program.
Conduct regular audits to ensure a comprehensive review of each market’s and department’s adherence to compliance standards and practices.
Schedules and performs internal audits.
Provide regular reports to the CCO to provide information to be presented to CFO, CRO, and CRIO pertaining to findings from the audits.
Prepare reports regarding finding of all audits to be presented by the CCO to the Board, CEO, COO, CFO, and CAO.
Maintain a monthly tracking mechanism of all internal audits including findings, mitigation of non-compliance, training, and refunds.
Complete Governmental Payor Enrollments including initial applications, renewals, revalidations, and updates.
Maintain and monitor a schedule of all governmental payor enrollments including timing of renewals and revalidations.
Coordinate the development of plans and training materials for correcting non-compliance items.
Maintain a clear tracking mechanism of all external audits. This should include at a minimum a log of all audits, audit findings, resolution, mitigation required, and refund status. This tracking document should at all times be ready to be presented in a professional manner to CCO,CRO, and ACRO.
Coordinate responses to all external audit requests, including governmental and regulatory audits or inquiries.
Coordinate and conduct meetings with RP, VPO, RCM, and DQA Managers to review findings of internal audits and maintain a record of those meetings including attendance and minutes.
Ensure compliance with federal, state, and local EMS regulations, including licensure, certification, and operational standards.
Oversee readiness and adherence to accreditation standards (e.g., Commission on Accreditation of Ambulance Services).
Monitor regulatory changes and translate requirements into actionable operational guidance.
Lead audit preparation, response, and corrective action planning.
Develop, implement, and maintain compliance-related policies, SOPs, and standard work.
Ensure policies are consistently applied across all markets while accounting for state-specific requirements.
Partner with Legal to review and update policies for regulatory alignment and risk mitigation.
Design and execute internal audit programs (clinical, operational, HR/compliance).
Identify compliance gaps and lead corrective action plans with measurable outcomes.
Oversee investigations related to compliance concerns, including coordination with Legal and HR.
Monitor trends and provide proactive recommendations to mitigate risk.
Partner with Training and Clinical teams to ensure required compliance training is assigned, tracked, and completed.
Support LMS governance to ensure regulatory training (OSHA, HIPAA, infection control, etc.) is current and standardized.
Develop compliance education strategies for leadership and frontline employees.
Ensure processes are in place to validate and track employee certifications (e.g., state licenses, CPR, driver qualifications).
Partner with Operations and HRIS to implement controls that prevent non-compliant scheduling (e.g., expired credentials).
Develop and maintain compliance dashboards and report for executive leadership.
Track key compliance metrics (audit results, training completion, certification status, incident trends).
Provide regular updates to executive leadership, including risk exposure and mitigation strategies.
Serve as a key advisor to Operations, HRBPs, and Executive Leadership on compliance-related matters
Collaborate with HRIS and IT to ensure systems (e.g., Paycom, ESO) support compliance requirements
Support integration efforts for new operations (e.g., acquisitions, startups) to ensure compliance alignment.