Vice President of Legal & Compliance

Behavioral Framework•Pittsburgh, PA

About The Position

Behavioral Framework - a leading provider of ABA therapy to children diagnosed with autism – is looking for a Vice President of Legal & Compliance! The Vice President of Legal & Compliance is the organization’s senior legal officer and the single point of accountability for healthcare regulatory compliance across all operating states. This role handles routine legal matters in-house and engages and manages outside counsel for specialized, high-stakes, or litigation matters. It also owns the enterprise compliance program: state licensing, payer compliance, HIPAA, corporate governance, and regulatory risk management. The dual reporting structure (to the CFO for day-to-day management and to the Board of Directors for compliance independence) ensures this role can surface regulatory risk and compliance concerns without organizational filtering. The Board receives direct compliance reporting on a defined cadence and has unimpeded access to this role. This role consolidates what was previously distributed: clinical compliance was partially in Clinical Services, employment compliance in HR, data privacy in IT, and corporate legal was managed ad hoc through outside counsel. The VP of Legal Compliance does not take ownership away from those functions; HR still executes employment law compliance, IT still implements HIPAA controls, but this role sets the standards, monitors adherence, and owns the enterprise compliance posture as a whole. Success is defined by clean regulatory audits, timely licensing and credentialing across all states, effective management of legal risk, and a compliance program that scales with the organization’s growth without creating operational drag.

Requirements

Juris Doctor (JD) from an accredited law school; active bar membership in at least one U.S. jurisdiction.
7+ years of legal experience with significant healthcare regulatory and compliance work.
Demonstrated experience managing a compliance program in a multi-state healthcare organization.
Experience managing outside counsel relationships and legal budgets.
Strong knowledge of healthcare regulatory frameworks: state licensing, Medicaid/commercial payer compliance, HIPAA, and accreditation standards.
Experience advising executive teams and presenting to boards of directors on legal and compliance matters.

Nice To Haves

Experience in ABA, behavioral health, or pediatric specialty services.
Healthcare Compliance (CHC) or similar compliance certification.
Experience supporting M&A transactions in healthcare, including due diligence and post-close integration.
Familiarity with Medicaid waiver programs and state-specific ABA licensing requirements.
Experience in a PE-backed, high-growth healthcare organization.

Responsibilities

Own the enterprise compliance program across all operating states: state ABA licensing requirements, Medicaid and commercial payer compliance, facility licensing, and accreditation standards.
Maintain a compliance calendar that tracks every state-specific licensing, renewal, and reporting obligation and ensures nothing lapses.
Conduct periodic internal compliance audits and risk assessments; own remediation plans and track them to closure.
Set compliance standards that HR, Clinical Services, Operations, and IT execute within their respective domains. Monitor adherence and escalate gaps.
Serve as the primary point of contact for state regulators, accreditation bodies, and payer compliance audits.
Manage the compliance training program: ensure all employees complete required compliance training on schedule, with tracking and documentation.
Serve as the organization’s HIPAA Privacy Officer (or designate and oversee one). Own HIPAA policies, breach notification procedures, and Business Associate Agreement management.
Set data privacy standards that IT implements and enforces; conduct periodic assessments of the organization’s HIPAA posture.
Manage breach response: investigation, notification, remediation, and reporting to HHS when required.
Handle routine legal matters in-house: contracts, vendor agreements, lease review, employment disputes, and corporate governance documentation.
Engage, manage, and oversee outside counsel for specialized matters: litigation, M&A due diligence, complex regulatory questions, and matters requiring jurisdictional expertise.
Manage the organization’s contract lifecycle: review and approve material contracts, maintain a contract repository, and ensure key terms and renewal dates are tracked.
Support M&A activity with legal due diligence, transaction documentation, and post-close integration of legal and compliance obligations.
Advise the CEO and executive team on legal risk associated with business decisions, new market entry, and organizational changes.
Ensure billing practices comply with Medicaid, commercial payer, and managed care requirements across all states.
Own the compliance infrastructure around coding, documentation, and claims submission (the rules and monitoring, not the billing execution) (which lives in Revenue Cycle or Finance).
Monitor for billing compliance risk: conduct periodic audits of claims data, flag patterns that suggest coding errors or documentation gaps, and drive corrective action.
Serve as the organization’s primary contact for payer compliance inquiries, audits, and corrective action plans.
Deliver quarterly compliance reports to the Board of Directors covering regulatory risk posture, open matters, audit results, and remediation status.
Maintain direct access to the Board for escalation of compliance concerns that cannot or should not be filtered through management.
Support corporate governance: board meeting preparation, corporate resolutions, entity management, and governance documentation.
Ensure the organization’s governance structure and documentation keep pace with growth, new entities, and multi-state operations.
HR executes employment law compliance; this role sets the standards and monitors adherence.
IT implements HIPAA controls and data security; this role sets the privacy requirements and audits the posture.
Clinical Services owns clinical compliance at the treatment level; this role owns the regulatory framework those clinical standards operate within.
Operations and Market Expansion own state entry logistics; this role owns the licensing and regulatory clearance required before services can launch.
VP of Client Experience owns intake operations; this role ensures intake processes comply with payer and regulatory requirements.