Scheduled Weekly Hours:40
Work Shift:Days (United States of America)
COMPLIANCE DIRECTOR | Work From Home/RemoteWFH/Remote anywhere in the US (Eastern/Central Time Zone Preferred)*We operate in the Eastern Time Zone*Reports to: System Director, Compliance - Quality & Patient Safety# of Direct Reports: 1***This Compliance Director will provide enterprise-wide compliance leadership for population health, care management, community health, and patient access functions, with primary responsibility supporting the ministry's ACO/CIN (Accountable Care Organization/Clinically Integrated Network) operations. This leader will partner closely with operational stakeholders to drive compliance monitoring, risk assessment, investigations, and regulatory readiness across value-based care initiatives. Prior ACO/CIN experience is required, along with deep expertise in healthcare compliance and CHC certification. ***Primary Function/General Purpose of PositionUnder the direct supervision of the System Director, Compliance, this position contributes to the Bon Secours Mercy Health mission and vision by developing and implementing the compliance workplan for their functional areas. This position implements the BSMH compliance program within their functional area and provides compliance related leadership and guidance for functional and market leaders. Conducts compliance investigations, education, auditing and monitoring and leads functional compliance committees.
Essential Job Functions- Implements the BSMH Compliance program within their assigned functional area, including application of leading practice approaches to identification, assessment, and mitigation of risks, auditing and monitoring, education of operational leaders on compliance regulations, establishing functional compliance committee, and implementing compliance policies.
- Completes education and conducts industry research to remain competent and effective in specific areas of focus as the Subject Matter Expert (SME) for Compliance risk area.
- Implements system wide compliance strategy and deployment of functional area compliance priorities and initiatives. Leads functional compliance committees across the system.
- Provides advice/consultation to functional leadership regarding compliance and regulatory initiatives impacting the Ministry and assist in mitigating risks to the organization. This will include presentations and education sessions on emerging risk areas relating to their functional areas.
- Assists in the development and evaluation of system-wide operational policies and procedures within their functional area.
- Leads compliance investigations, work collaboratively with Advice and Counsel, conducts interviews, documents investigatory steps, and makes recommendations for corrective actions. Prepares and documents investigation file within the compliance tracking system.
- Serves as market and / or functional area compliance contact with responsibility for reporting to Market Board and market senior leadership. Coordinates compliance issues that arise with the appropriate functional Director, Compliance.
- Develops monitoring and auditing protocols specific to compliance functional risk areas highlighted by the OIG, Medicare, State Medicaid, State Insurance Fraud; Managed Care or Governmental Value-Based payment programs and/or other enforcement agencies as part of the overarching BSMH compliance program.
- Evaluates and utilizes data analytics techniques, statistical analysis and modeling, and databases developed internally, or in conjunction with other third-party vendors to detect and trend potential compliance issues.
- Prepares updates relative to functional area for presentation at Compliance Leadership meetings.
- Effectively and respectfully communicates with internal and external stakeholders. Meets deadlines and responds to requests appropriately.
- Participates in various ad-hoc and/or established BSMH committees to provide Compliance support and perspective, and shares identified risks with Compliance Leaders for awareness and collaborative mitigation planning.
- Identifies the need and develops educational content and trending of non-compliant activities to enhance proficiency and competency, understanding of standards and the consequences of non-compliance. Prepares multi-faceted oral, written and electronic communications and presentations to facilitate discussion, networking, decision-making and proactive responses to meet current and emerging challenges among affected parties and entities.
- Hires, trains, coaches, counsels, manages and evaluates performance of direct reports within assigned functional areas.
Licensing/CertificationCertified in Healthcare Compliance (CHC) - Health Care Compliance Association (required)
EducationBachelors: Healthcare, Business Administration, or Related Field (required)
Masters: Healthcare, Business Administration, or Related Field (preferred)
Work Experience7 to 10 years of in-depth experience within healthcare operations or compliance-related activities (required)
Skills:Hard/Tech/Clinical Skills:- Demonstrate expert-level understanding of healthcare regulations (HIPAA, GDPR, DPA, CMS, OIG, Stark, Anti-Kickback, etc.) and compliance operations.
- Oversee enterprise compliance auditing, monitoring and investigations.
- Design and operationalize compliance presence within assigned functional areas.
- Identify, assess and mitigate compliance risks through structured risk management frameworks.
- Leverage AI, analytics, and reporting tools (Microsoft Copilot, Power BI, or similar) and healthcare databases and technologies for compliance insights.
- Oversee development and revision of compliance policies to maintain regulatory alignment.
- Conduct in-depth regulatory research and provide actionable interpretations to leadership.
- Design and deliver engaging presentations, training programs, and educational courses.
- Recruit, mentor and manage compliance staff and leaders.
- Experience managing conflict of interest and exclusion screening programs
Soft/Interpersonal Skills:- Apply strategic critical thinking and judgment to complex compliance issues.
- Demonstrate strong communication and presentation skills with executive audiences.
- Craft and deliver clear, concise, and persuasive messages.
- Build and sustain trust and credibility across the organization.
- Engage collaboratively with cross-functional teams and key stakeholders.
- Navigate changing priorities and evolving regulations with agility.
- Exhibit integrity, ethical leadership, and dedication to compliance culture.
- Provide strong leadership and conflict resolution abilities.
- Mentor and develop compliance professionals for growth and succession.
- Demonstrate initiative and autonomy in driving multiple compliance priorities.
What we offer- Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
- Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
- Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
- Tuition assistance, professional development and continuing education support
Benefits may vary based on the market and employment status.
Department:SS Enterprise Risk - Corp Responsibility
