As our System Director of Compliance Monitoring and Data Analytics, you will serve as a strategic leader responsible for designing, implementing, and maintaining system-wide compliance monitoring processes. You will play a pivotal role in transforming complex operational and financial data into actionable intelligence, ensuring the organization remains aligned with federal and state healthcare regulations. By leveraging advanced data analytics, audit methodologies, and emerging AI technologies, you will safeguard the organization against vulnerabilities and drive a culture of proactive risk mitigation.

Every day you will oversee the day-to-day operations of the compliance monitoring and revenue cycle monitoring functions, ensuring that all activities align with the annual Corporate Responsibility (CR) monitoring plan. You will collaborate with cross-functional stakeholders—including Legal, Clinical Services, IT, and Revenue Cycle leadership—to identify risks and facilitate effective corrective action plans. Your work will involve managing audit teams, refining data collection systems, and validating data integrity to ensure high-quality reporting and transparency across the enterprise.

To be successful in this role, you will possess deep expertise in healthcare compliance, data governance, and statistical analysis. You will be a proactive problem-solver who can translate regulatory requirements into efficient, scalable monitoring strategies. Your ability to lead high-performing teams, manage vendor relationships, and advocate for continuous improvement through the integration of new technologies will be essential to mitigating organizational risk and maintaining long-term regulatory excellence.

Essential Key Job Responsibilities:

• Strategic Compliance Leadership: Design and execute the annual CR monitoring plan, directing the monitoring administration and revenue cycle oversight teams to ensure timely reporting and risk mitigation.
• Data-Driven Analytics: Develop comprehensive data management plans and utilize statistical methods to detect anomalies, billing irregularities, and medical necessity risks.
• Regulatory Oversight: Monitor evolving federal and state laws, translating legislative changes into actionable monitoring strategies and updated audit methodologies.
• Cross-Functional Collaboration: Partner with IT and clinical stakeholders to secure data access, validate information reliability, and implement robust corrective action plans.
• Innovation & Technology: Champion the continuous improvement of compliance programs by integrating advanced auditing tools, AI-driven monitoring agents, and modern statistical sampling techniques.
• Operational Excellence: Manage external vendor engagements, standardize audit documentation templates, and ensure that all findings are clearly communicated to leadership to drive organizational accountability.

Requirements: 

• Bachelor’s degree in Data Science, Health Care Administration, Finance, or Statistics required (Master’s preferred).
• One of the following is preferred upon hire or required within first year of employment:
  • Certification in Health Care Compliance (CHC)
  • Certified Compliance and Ethics Professional (CCEP)
  • Certification in healthcare research compliance (CHRC)
  • Registered Health Information Administrator (RHIA)
  • Registered Health Information Technician (RHIT)
  • Certified Coding Specialist (CCS)
• Minimum of 8 years of progressive experience, including at least 3 years in a supervisory capacity.

• Minimum of six (6) years’ progressive leadership experience in the health care field.

• Knowledge of Federal and state laws and regulations including, CMS billing requirements, False Claims Act, OIG Work Plans, Stark, Anti-Kickback Statute, and HIPAA. 
• Computer skills and proficiency in Google ( Docs, Sheets, Slides,etc), data analysis tools and compliance software.  Expert level skills in Google sheets and Microsoft Excel.
• Analytical, problem solving, and critical thinking skills with the ability to interpret complex data and identify trends.
• Strong leadership skills with the ability to influence and collaborate effectively across all levels of the organization.