Director of Compliance

Job Summary

A company is looking for a Director of Compliance to oversee compliance operations related to First Tier, Downstream, and Related Entities in the Medicare sector.

Key Responsibilities

• Manage processes related to First Tier, Downstream, and Related Entities, ensuring compliance with regulatory requirements
• Conduct internal audits and develop audit tools to track compliance issues and oversee corrective actions
• Support regulatory communications and assist with Federal and State audits as needed

Required Qualifications

• 7-10 years of relevant business or compliance experience, with at least 5 years focused on CMS Medicare regulations
• Experience in managing compliance programs within the Medicare Advantage sector
• Auditing experience with internal business areas and external vendors
• Ability to develop and implement compliance objectives and processes
• Certification in Healthcare Compliance (CHC) is preferred