Director of Compliance

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description: The Director of Compliance is responsible for developing, implementing, and overseeing the organization's Corporate Compliance Program across all physician practice locations. This position ensures compliance with federal, state, and local laws and regulations governing physician practices, specialty oncology services, infusion centers, pharmacy operations, laboratory services, and clinical research (if applicable). The Director serves as a strategic advisor to executive leadership while promoting a culture of ethics, integrity, and regulatory compliance.

Essential Duties and Responsibilities: Corporate Compliance ProgramDevelop, implement, and maintain an effective Corporate Compliance Program. Conduct annual enterprise-wide compliance risk assessments. Develop annual compliance work plans based on identified risks. Present compliance reports to Executive Leadership and the Board or Compliance Committee. Maintain the organization's Code of Conduct and compliance policies. Regulatory ComplianceEnsure compliance with: Centers for Medicare & Medicaid Services (CMS) California Department of Public Health (CDPH) California Medical Board requirements California Department of Health Care Services (DHCS) Office of Inspector General (OIG) Department of Justice (DOJ) HIPAA Privacy and Security Rules OSHA California labor regulations affecting healthcare operations Federal and California Fraud, Waste, and Abuse laws False Claims Act Anti-Kickback Statute Stark Law Medicare and Medi‑Cal regulations Physician Practice Compliance Monitor compliance across multiple satellite physician offices. Ensure provider credentialing and licensure compliance. Oversee medical record documentation compliance. Evaluate coding and billing practices. Monitor incident-to billing requirements. Oversee provider enrollment compliance. Coordinate internal compliance audits. Oncology‑Specific ComplianceMonitor chemotherapy and biologic administration compliance. Ensure compliance with infusion center standards. Oversee hazardous drug handling standards. Monitor oral oncology dispensing compliance (if applicable). Ensure compliance with prior authorization requirements. Support oncology quality initiatives. Assist with accreditation readiness (e.g., oncology‑specific accreditation programs). Privacy and HIPAAServe as Privacy Officer or collaborate closely with the Privacy Officer. Investigate privacy incidents and breaches. Oversee HIPAA training. Conduct HIPAA risk assessments. Ensure Business Associate Agreements are maintained. Auditing and MonitoringDevelop and oversee audits including: Medical record documentation Evaluation & Management coding Chemotherapy administration documentation Infusion billing Modifier usage Incident-to billing Medical necessity Clinical documentation integrity Provider documentation Laboratory compliance Pharmacy compliance InvestigationsInvestigate compliance concerns. Manage anonymous reporting hotline. Conduct internal investigations. Recommend corrective actions. Monitor corrective action plans.

Education and Training: Develop annual compliance education for Physicians, Advanced Practice Providers, Nurses, Medical Assistants, Clinical Research staff, Revenue Cycle Front Office staff, Leadership. Develop and revise compliance‑related policies. Ensure policies remain current with changing regulations. Standardize compliance practices across all satellite offices. Risk ManagementPerform compliance risk assessments. Identify emerging regulatory risks. Develop mitigation strategies. Monitor corrective actions. Accreditation and Regulatory SurveysCoordinate readiness for organizations such as: Accreditation surveys, State inspections, CMS audits, OIG audits, Commercial payer audits. Revenue Cycle ComplianceCollaborate with Revenue Cycle to monitor: Coding accuracy, Charge capture, Billing compliance. Refunds and overpayments. Credit balance management. Denials related to compliance. Clinical Research ComplianceEnsure compliance with research regulations. Monitor informed consent requirements. Coordinate with Institutional Review Boards (IRBs). Support Good Clinical Practice (GCP) standards. Pharmacy ComplianceMonitor specialty pharmacy regulations. Ensure compliance with drug storage requirements. Oversee controlled substance policies. Monitor drug diversion prevention. QualificationsEducation: Bachelor's degree required. Master's degree in Healthcare Administration, Business Administration, Public Health, Nursing, Law, or related field preferred.

Experience: 8‑10 years of progressive healthcare compliance experience. At least 5 years in physician practice compliance. Multi‑site healthcare organization experience required. Oncology experience strongly preferred. Experience with Medicare and Medi‑Cal regulations. Experience managing compliance investigations and audits.

Preferred Certifications: Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified Professional Coder (CPC) (preferred), Registered Health Information Administrator (RHIA) (preferred).

Knowledge and Skills: Extensive knowledge of physician practice regulations, Oncology regulatory expertise, Medicare and Medi‑Cal billing compliance, HIPAA Privacy and Security, Fraud, Waste, and Abuse regulations, Stark Law and Anti‑Kickback Statute, Healthcare auditing methodologies, Risk assessment and mitigation, Policy development, Strong leadership, communication, and project management skills.

Salary Transparency: Exact compensation may vary based on skills, education, certifications, experience, and location. Base Salary Range from $130,000.00 to $165,000.00.