Vice President of Quality, Risk, and Compliance & Chief Compliance Officer - Quality Improvement

Bay Cove Human Services, Inc.•Boston, MA

20h

About The Position

The Vice President of Quality, Risk, and Compliance & Chief Compliance Officer (CCO) is a senior executive responsible for leading enterprise-wide compliance, risk management, and quality improvement functions for Bay Cove Human Services, a multi-service human services organization in Massachusetts. Bay Cove Human Services' mission is to partner with people to overcome challenges and realize personal potential by providing individualized and compassionate services to people facing developmental disabilities, mental illness, substance use disorders, and homelessness at more than 175 program sites throughout Greater Boston and Southeastern Massachusetts. This role ensures adherence to all applicable federal and Massachusetts regulatory requirements across diverse programs, including behavioral health, developmental services, addictions services, homeless services, and housing. The VP/CCO partners closely with executive leadership and the Board to promote a culture of safety, accountability, and continuous quality improvement, while ensuring readiness for audits, licensure reviews, and accreditation.

Requirements

Bachelor’s Degree (e.g., Public Health, Healthcare Administration, Social Work, Business, or related field).
Minimum of 10–12 years of progressive leadership experience in compliance, risk, and/or quality in human services, behavioral health, or healthcare.
Demonstrated experience operating within Massachusetts regulatory environments and managing multi-agency oversight.
Deep knowledge of Massachusetts regulatory frameworks, including Medicaid (MassHealth), licensing, and human services program requirements.
Strong understanding of incident reporting and protective services systems.
Strong understanding of privacy laws including HIPAA and 42 CFR Part 2.
Strong understanding of accreditation and survey readiness.
Expertise in enterprise risk management and CQI methodologies.
Ability to translate complex regulatory requirements into operational practices.
Strong executive presence with the ability to influence at all levels, including Board governance.
Candidates must be authorized to work in the United States.

Nice To Haves

JD, MPH, or MBA preferred.
Expertise in CQI methodologies (e.g., Lean, Six Sigma preferred).
Certified in Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP).
Certified Professional in Healthcare Quality (CPHQ) or equivalent.
Risk management certification (e.g., ARM) preferred.

Responsibilities

Serve as the organization’s Chief Compliance Officer, responsible for the design, implementation, and oversight of an effective compliance program aligned with federal and Massachusetts requirements.
Ensure compliance with applicable regulatory and funding bodies, including MassHealth (Medicaid), Massachusetts Department of Mental Health (DMH), Massachusetts Department of Developmental Services (DDS), Massachusetts Department of Public Health (DPH), and Massachusetts Executive Office of Housing and Livable Communities (EOHLC).
Monitor and interpret changes in federal and state regulations (e.g., Medicaid, licensing, 42 CFR Part 2, Health Insurance Portability and Accountability Act) and operationalize requirements across programs.
Lead organizational response to audits, licensing reviews, and investigations; serve as primary liaison with regulators.
Oversee compliance hotline, investigations, and enforcement of compliance policies.
Ensure organizational readiness for complex external risk and compliance reviews, including large-scale third-party assessments.
Lead the organization’s Enterprise Risk Management (ERM) framework, tailored to human services delivery in Massachusetts.
Oversee incident reporting systems (including reportable events to state agencies), investigations, and corrective action planning.
Ensure compliance with mandated reporting requirements.
Direct insurance programs, claims management, and loss prevention strategies.
Provide regular risk dashboards and reports to executive leadership and Board committees.
Design and lead a comprehensive Quality Management Program aligned with Massachusetts regulatory expectations and payer requirements.
Establish and monitor KPIs tied to outcomes such as service quality, safety, access, and equity.
Lead Continuous Quality Improvement (CQI) initiatives using data analytics and evidence-based practices.
Ensure readiness for and oversight of accreditation processes.
Align quality initiatives with value-based care and alternative payment models under MassHealth.
Serve as a key member of the Executive Leadership Team.
Advise the CEO and Board (e.g., Compliance/Audit Committee) on regulatory risk, compliance trends, and quality outcomes.
Develop and execute a multi-year compliance, risk, and quality strategy aligned with organizational goals.
Collaborate across service lines, leadership teams, and agency departments to support integrated operations.
Build and lead a multidisciplinary team of directors who will serve as functional leads across compliance, quality, and risk functions.
Ensure clear delineation of responsibilities across teams, recognizing the breadth and complexity of the function.
Develop and implement organization-wide training programs on compliance, ethics, privacy, and risk.
Promote a culture that encourages reporting, learning, and continuous improvement.
Ensure staff understand Massachusetts-specific regulatory requirements and program expectations.
Maintain and regularly update the organization’s Code of Conduct.