Director of Compliance - Concord, CA

PLANNED PARENTHOOD SHASTA-DIABLO•Concord, CA

1d•$133,200 - $165,200•Onsite

About The Position

The Director of Compliance leads Planned Parenthood Northern California’s (PPNorCal) healthcare compliance program and provides oversight of patient privacy, regulatory compliance, and enterprise risk management activities. Reporting to the General Counsel, the Director serves as a senior compliance advisor to organizational leadership, identifying and assessing compliance risks and partnering with leaders to develop practical, effective solutions. The Director oversees compliance monitoring, auditing, investigations, and corrective action; leads the Risk and Quality Management (RQM) program; and supports organizational readiness for regulatory and accreditation requirements. The Director promotes a culture of compliance and accountability across the affiliate and provides leadership to staff supporting compliance, privacy, and risk management activities.

Requirements

Bachelor’s degree required; degree in healthcare administration, business, public health, law, compliance, or a related field preferred.
Minimum seven (7) years of progressively responsible experience in healthcare compliance, regulatory compliance, privacy, risk management, auditing, or a related field.
Experience working within a health plan/payer, hospital or health system, medical group, clinic, community health center, or other regulated healthcare organization.
Demonstrated experience leading or materially contributing to a healthcare compliance program, including compliance monitoring, investigations, risk assessment, and corrective action.
Experience advising senior leaders on healthcare compliance and regulatory risk.
Strong knowledge of healthcare compliance principles and the elements of an effective compliance program.
Demonstrated understanding of healthcare operations and the regulatory environment in which healthcare organizations operate.
Strong analytical and critical-thinking skills, including the ability to assess complex regulatory and operational issues, identify material compliance risks, and develop practical, risk-based recommendations.
Ability to translate complex regulatory requirements into clear, actionable guidance for organizational leaders and staff.
Sound judgment, including the ability to independently manage compliance matters and recognize when legal, executive, or Board-level escalation is appropriate.
Excellent written, verbal, presentation, and interpersonal communication skills, with the ability to influence and collaborate effectively across departments and levels of leadership.
Demonstrated leadership and ability to manage multiple priorities and complex initiatives in a highly regulated environment.
Ability to maintain strict confidentiality and appropriately handle sensitive information.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents.
Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
Ability to write documents for publication that conform to prescribed style and format.
Ability to work with top management, public groups, and/or the boards of directors.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Proficiency with Microsoft Word, Excel, Outlook, electronic health record (EHR) and practice management systems, and compliance, auditing, or incident-management technology.
Ability to effectively use data and reporting tools to support compliance monitoring and risk assessment.
Access to Protected Health Information only as necessary to perform compliance, privacy, risk management, healthcare operations, investigation, auditing, and other authorized responsibilities consistent with applicable law and organizational policy.

Nice To Haves

Experience with California healthcare regulatory requirements, 340B compliance, and healthcare accreditation preferred.
Certified in Healthcare Compliance (CHC) preferred; if not certified at time of hire, certification must be obtained within twelve (12) months.
Certified in Healthcare Privacy Compliance (CHPC) preferred.

Responsibilities

Lead the development, implementation, and ongoing evaluation of PPNorCal’s healthcare compliance program consistent with applicable regulatory guidance and the elements of an effective compliance program.
Develop and execute an annual, risk-based compliance work plan informed by regulatory requirements, organizational risk assessments, audit findings, and emerging compliance risks.
Monitor developments in federal and California healthcare laws, regulations, regulatory guidance, enforcement activity, and accreditation requirements; assess organizational impact and coordinate appropriate response.
Advise the General Counsel and organizational leadership regarding healthcare compliance risks, emerging issues, and recommended mitigation strategies.
Develop and maintain compliance policies, procedures, training, and communications in partnership with organizational stakeholders.
Develop and oversee risk-based compliance monitoring and auditing activities, including coding and billing audits and other regulatory reviews within the scope of the compliance program.
Analyze monitoring and audit findings to identify trends, systemic issues, and areas of organizational risk; partner with responsible leaders to develop corrective action plans and monitor remediation through completion.
Oversee the Compliance Hotline and direct compliance investigations, including assessment, documentation, root-cause analysis, corrective action, and appropriate escalation.
Lead organizational readiness for PPFA accreditation and other compliance or regulatory reviews, partnering with clinical and operational leaders to assess readiness, identify gaps, coordinate responses to findings, and monitor corrective actions.
Provide compliance oversight of the affiliate's 340B Drug Pricing Program, including monitoring, auditing, policy development, and corrective action.
Ensure appropriate documentation and reporting of compliance program activities, investigations, monitoring, auditing, corrective actions, and identified violations.
Serve as the operational lead for the organization’s HIPAA and patient privacy program under the oversight of the General Counsel.
Develop and maintain privacy policies, procedures, training, and controls consistent with applicable federal and California requirements.
Assess and investigate privacy complaints, incidents, and potential breaches and recommend appropriate mitigation, notification, and corrective action.
Coordinate required regulatory reporting and notifications in consultation with the General Counsel.
Partner with organizational stakeholders to identify and mitigate privacy risks and support compliance with patient privacy rights and Business Associate requirements.
Provide privacy compliance oversight for research and other organizational activities involving protected health information.
Lead the affiliate’s Risk and Quality Management (RQM) program in partnership with clinical, operational, and executive leadership.
Chair the Risk and Quality Management Team and oversee the organizational risk assessment and RQM work-planning processes.
Identify and monitor significant compliance, regulatory, privacy, and operational risks and associated mitigation efforts.
Prepare periodic and annual RQM reporting for the General Counsel, executive leadership, CEO, and Board of Directors, as appropriate.
Serve as a senior compliance and risk resource regarding patient incidents presenting elevated regulatory or organizational risk.
Serve as a trusted healthcare compliance advisor to the General Counsel, executive leadership, and organizational stakeholders, translating complex regulatory requirements into practical, risk-based guidance.
Build effective partnerships across clinical, operational, financial, human resources, information technology, and administrative functions to advance organizational compliance priorities.
Prepare and present compliance risks, audit findings, trends, and recommendations to executive leadership and the Board of Directors, as appropriate.
Provide functional leadership and subject-matter guidance to Legal & Compliance team members and support the coordination and prioritization of departmental compliance activities.
Serve as a senior departmental resource and provide continuity for Legal & Compliance matters during the General Counsel’s absence, within established authority and escalation protocols.
Represent the organization at healthcare compliance meetings, trainings, and other external forums as appropriate.
Support organizational initiatives, including Diversity, Equity, and Inclusion (DEI), through leadership and participation.