Director of Compliance

We are hiring for:

Director of Compliance

Type:

Regular

If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services!  

The Director of Compliance directs day-to-day operations of the enterprise Compliance Program and serves as a key leader to the Chief Compliance Officer. This role oversees the privacy program, sanction/exclusion screening, investigations, policy management, and compliance reporting while building and sustaining an effective program aligned to OIG elements, HIPAA/HITECH, state HCBS/IDD requirements, and payer rules across multiple states. It expands on existing responsibilities for hotline management, sanction checking, investigations, policy/procedure oversight, conflict-of-interest disclosures, annual training planning, privacy program leadership, and compliance analytics/reporting.

DUTIES AND RESPONSIBILITIES:

Program Leadership & Governance

• Operationalize and continuously improve an enterprise Compliance Program aligned to OIG’s seven elements (standards, oversight, education, communication, auditing/monitoring, enforcement/discipline, response/prevention).
• Maintain the Compliance Charter, annual work plan, and a written standards/code of conduct; ensure consistent deployment across all states and service lines.
• Coordinate the enterprise compliance risk assessment and translate results into prioritized mitigation plans and monitoring.

Policies, Education, and Communications

• Own the lifecycle (draft/review/approve/archive) of Compliance and Privacy policies, SOPs, and document-retention standards; ensure alignment to federal/state HCBS waiver, Medicaid/Medicare, and commercial payer requirements.
• Define the annual training strategy and calendar; develop role-based education (general compliance, HIPAA privacy/security basics, fraud/waste/abuse, conflicts, documentation standards).
• Maintain accessible FAQs, toolkits, and targeted communications to reinforce standards and lessons learned.

Hotline and Compliance Investigations Support

• Support confidential reporting channels (hotline, web, internal reports) by ensuring proper intake, triage, and documentation in alignment with established protocols.
• Assist in compliance investigation processes by coordinating case information, maintaining records, and ensuring timely escalation of matters as needed.
• Monitor case progress for adherence to protocols such as retaliation-prevention, documentation standards, and closure requirements.
• Manage compliance platforms (e.g., Resolver, Diligent, or other designated systems), ensuring data integrity, reporting accuracy, and user access controls.
• Track and summarize trends, case metrics, and system usage to support compliance oversight and reporting needs.

Sanction/Exclusion Screening & Conflicts of Interest

• Oversee OIG/GSA/state Medicaid exclusion screening for employees, contractors, and vendors; ensure timely remediation of matches and documentation.
• Administer the annual Conflict-of-Interest disclosure process and manage follow-ups, mitigation, and Board/leadership reporting.

Privacy & Security Collaboration

• Lead the operational Privacy Program (in partnership with Security/IT): incident intake, assessment, breach determination/notifications, mitigation, and prevention education.
• Ensure Business Associate Agreement governance, minimum necessary standards, and PHI safeguarding practices; coordinate with InfoSec on incidents that intersect privacy/security.

Auditing, Monitoring, and Analytics

• Build an annual audit/monitoring plan (documentation standards, billing/claims risk areas, exclusion screening, training completion, policy adherence).
• Deploy dashboards and KPIs for leadership and oversight committees (e.g., hotline volumes, time-to-first-action, time-to-closure, trends by region, training completion, policy exceptions).
• Validate corrective action effectiveness and sustainment; escalate unresolved risks.

Regulatory & Payer Interface

• Coordinate responses to government inquiries, surveys, and audits; manage timely external notifications when required by law/regulation or payer contract.
• Maintain a regulatory calendar (reportable events, timelines, renewal/attestation dates) and ensure state-specific requirements are met for IDD/behavioral health, HCBS, residential/d