Senior Director of Compliance

Job Title: Sr. Director of Compliance

Compensation Range: $165,000 - $200,000

Position Summary

The Senior Director of Compliance provides strategic leadership, guidance, and oversight of the organization's enterprise-wide compliance program across community-based services, home care, home health, hospice, senior living, and medical group operations. Reporting to the Chief Administrative Officer, this leader serves as a trusted advisor to executive leadership and key stakeholders, ensuring compliance with applicable federal and state healthcare regulations, licensure requirements, accreditation standards, and organizational policies.

Position Functions and Responsibilities

• Strengthen policies, procedures, and internal controls that support regulatory compliance and ethical business practices.
• Develop and oversee compliance education and training programs for leaders and employees.
• Promote a culture of integrity, accountability, and ethical decision-making throughout the organization.
• Lead efforts to improve compliance monitoring, reporting, and documentation processes.
• Design, implement, and continuously improve a comprehensive, organization-wide compliance program consistent with the OIG's Seven Elements of an Effective Compliance Program, tailored to community home care, medical group, home health, hospice, and senior living operations.
• Serve as the organization's designated Compliance Officer and HIPAA Privacy Officer, overseeing adherence to federal and state privacy, security, and fraud, waste, and abuse regulations.
• Monitor compliance with CMS Conditions of Participation for home health, hospice, and medical group and with state licensure and regulatory requirements for community home care, assisted living, independent living, and skilled nursing communities.
• Track federal, state, and local regulatory and legislative changes affecting community home care, medical group, home health, hospice and senior living operations, and translate them into updated policies, procedures, and workflows.
• Lead the enterprise risk assessment, audit, and monitoring program, prioritizing review areas across clinical, billing, admissions, and operational functions.
• Own the compliance hotline and internal reporting channels; oversee intake, investigation, and resolution of reported concerns, including corrective action plans and follow-up monitoring.
• Direct OIG/GSA exclusion screening, license and certification verification, and background screening processes for employees, contractors, and vendors, in partnership with Human Resources.

• Monitor federal and state regulatory changes and assess organizational impact.
• Oversee compliance audits, assessments, investigations, and corrective action planning.
• Ensure adherence to healthcare regulations, privacy requirements, billing and reimbursement standards, and licensing obligations.
• Collaborate with legal, human resources, clinical, operational, and quality teams to address compliance concerns and emerging risks.
• Maintain organizational readiness for surveys, inspections, and accreditation reviews.
• Prepare and present regular compliance reporting, risk assessments, and program updates to the executive leadership team and Board of Directors.
• Lead survey and audit readiness across all lines of business, and manage the organization's response to state surveys, CMS audits, and accreditation reviews (e.g., ACHC, CHAP, Joint Commission).
• Develop and deliver compliance, ethics, and HIPAA training for staff, management, and the Board, and maintain training completion records.
• Partner with Revenue Cycle and Clinical Operations leadership to monitor billing and coding practices, documentation integrity, and Medicare/Medicaid regulatory compliance.
• Oversee self-disclosure protocols, overpayment identification, and voluntary refund processes in coordination with legal counsel and finance.
• Lead root-cause analysis for compliance incidents and near-misses and drive systemic corrective action to reduce recurrence.
• Manage privacy and security incident response, including breach risk assessments and required regulatory notifications.
• Partner with General Counsel on regulatory inquiries, investigations, subpoenas, and litigation holds involving compliance matters.
• Champion a culture of ethics, transparency, and accountability across the organization through visible leadership and consistent messaging.

Partnership & Influence

• Build trusted relationships with leaders across the organization through responsiveness, expertise, and practical problem-solving.
• Coach leaders on compliance expectations while balancing operational needs and organizational objectives.
• Foster collaboration between compliance and operational teams to support sustainable growth.
• Influence decision-making through data, risk analysis, and regulatory insight.

Qualifications

• Bachelor's degree in healthcare administration, Business, Nursing, Law, or a related field required; master's degree in a related field.
• Minimum of 8-10 years of progressive compliance experience within community home care, medical group, home health, hospice, senior living, or another regulated post-acute or senior care setting, including at least 3 years in a compliance leadership role.
• Working knowledge of CMS Conditions of Participation, OIG Compliance Program Guidance, HIPAA, the False Claims Act, Anti-Kickback Statute, Stark Law, and applicable state licensure regulations for community home care, home health, hospice and senior living.
• Demonstrated experience designing and administering compliance programs, conducting risk assessments, and leading internal audits or investigations.
• Solid understanding of Medicare/Medicaid billing, coding, and documentation requirements as they relate to compliance risk.
• Strong leadership presence and communication skills, with the ability to advise the senior leaders, the Board, and regulators with clarity and confidence.
• Proven track record managing sensitive investigations, corrective action plans, and regulatory reporting.
• Valid driver's license and ability to travel periodically among company locations including senior living communities.
• Healthcare Compliance Certification (CHC) or other relevant compliance credential.
• Experience supporting multi-site healthcare or post-acute care organizations.
• Experience working directly with executive leadership and governance committees.

Knowledge / Skills:

• In-depth knowledge of federal and state healthcare regulations and OIG Compliance Program Guidance applicable to community home care, medical group, home health, hospice, and senior living providers.
• Skilled in policy development, training design, and risk assessment and audit methodologies.
• Proficient with compliance management systems, case/incident tracking tools, and Microsoft Office.
• Strong analytical, investigative, and project management skills, with the ability to manage multiple priorities simultaneously.
• Sound judgment, discretion, and a high degree of personal and professional integrity.
• Ability to build trust and collaborate effectively across clinical, operational, legal, and executive teams.

Physical Demands

The following physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Work is primarily sedentary; the employee regularly (67-100% of the time) sits, uses hands and fingers to operate a computer and phone, and talks and hears.
• The employee is occasionally required (1-33% of the time) to stand, walk, bend, reach, and climb stairs, including during site visits, audits, and survey activities.
• The employee must occasionally lift, move, and/or carry up to 10 pounds (e.g., files, laptop, presentation materials).
• Specific vision abilities required include close vision and the ability to adjust focus for extended computer and document review work.
• Regular travel by car or air to company locations, regulatory meetings, and industry conferences is required; ability to travel independently is necessary.

Work Environment

• Work is performed primarily in a professional office environment that is well-lit, clean, and hazard-free, with standard office equipment maintained in good operating condition.
• Periodic travel to home health branch offices, senior living communities, and other company sites is required, which may include exposure to typical healthcare and residential care settings.

Physical Demands
The following physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Walking/mobility, reaching, bending, lifting or repositioning residents, grasping, pushing medication carts, pulling, fine hand coordination, ability to hear and respond to pages, ability to understand and follow written and oral instructions and directions, ability to read and write and do mathematical percentile, ability to communicate with the residents and others, ability to distinguish smells, tastes, and temperatures, and ability to remain calm in emergency situations and when handling multiple tasks.