Head of Compliance

📋 Description

• Lead healthcare compliance strategy: Develop, implement, and maintain a comprehensive compliance
• Oversee PC-MSO compliance: Ensure the organization's professional corporation and management
• Manage HIPAA privacy and security: Lead the organization's privacy and security program, including
• Audit coding and billing practices: Review Medicare Part B coding and billing for care management
• Oversee revenue cycle compliance: Evaluate end-to-end revenue cycle management processes, including
• Monitor regulatory developments: Track annual Medicare Physician Fee Schedule updates, NCCI edits

🎯 Requirements

• At least seven years of experience in healthcare compliance, with substantial hands-on
• Deep working knowledge of Medicare, Medicaid, and commercial insurance requirements, including
• Direct experience working with a professional corporation and management services organization
• Strong understanding of HIPAA, the Anti-Kickback Statute, Stark Law, and the False Claims Act
• Familiarity with Medicare coding requirements and reimbursement changes affecting care management
• Practical knowledge of eligibility verification, claim submission, denials, appeals, patient

🎁 Benefits

• Flexible part-time arrangement: Fractional leadership opportunity with flexible working hours.
• Remote work: Work remotely from within the United States.
• Strategic leadership impact: Shape the compliance strategy and regulatory foundation of a growing
• Broad organizational influence: Collaborate with clinical, operational, legal, and technical teams
• Innovation-focused environment: Help integrate regulatory safeguards into technology-enabled care
• Meaningful mission: Contribute to improving how Medicare patients navigate healthcare and access