Compliance Manager

Audit Readiness & Risk Management 

• Conduct internal audits and compliance reviews 

• Lead payer audit preparation and response support 

• Manage HIPAA Security Risk Assessments and remediation efforts, internally or through vendors 

• Identify and mitigate regulatory risk before it becomes operational or financial exposure 

 Healthcare Regulatory Compliance 

• Ensure compliance with key healthcare regulations including HIPAA, HITECH, state licensing requirements, telehealth regulations, and payer compliance obligations. 

• Monitor regulatory changes across the healthcare landscape and translate requirements into operational policies and procedures. 

• Support clinical and operational teams in maintaining compliance with documentation, privacy, and care delivery requirements. 

• Oversee compliance for telehealth 

• Ensure compliance with HIPAA Privacy and Security, Anti-Kickback Statute, Stark Law, CMS rules, and state regulations 

• Review clinical workflows, documentation standards, and care team roles for regulatory alignment 

• Evaluate new service lines, partnerships, and initiatives for compliance and reimbursement risk 

• Ensuring proper operating procedures are in place for compliance relating to employee onboarding and client admissions, clinical documentation, treatment, and discharge. 

Privacy & Data Protection 

• Partner with IT and Security teams to oversee HIPAA privacy and security compliance, including policies governing PHI, access controls, and incident response. 

• Lead internal investigations related to potential privacy or compliance violations and coordinate remediation efforts. 

Risk Management & Auditing 

• Conduct periodic compliance risk assessments and internal audits across clinical, operational, and technical systems. 

• Develop corrective action plans when gaps are identified and ensure timely resolution. 

• Prepare the organization for regulatory reviews, audits, and accreditation processes when applicable. 

• Conducts bench testing/auditing of business activities to confirm that compliance controls are operating effectively. 

• Leverages data analytics and investigative techniques to identify compliance trends, assess risks, and share actionable insights with key stakeholders. 

• Assist to ensure that ongoing regulatory and accreditation requirements such as internal inspections, written assessments, and emergency drills are completed on time. 

Cross-Functional Collaboration 

• Work closely with Legal, HR, Clinical Leadership, IT, Security, and Operations to integrate compliance practices into day-to-day workflows. 

• Support vendor and partner compliance reviews, including due diligence related to data privacy and regulatory obligations. 

• Review marketing, patient communications, and external materials for compliance risk 

• Advise leadership on MSO and medical group structural compliance and contracting considerations 

• Monitor regulatory changes and brief leadership on impact and required actions 

 On-site Clinic Compliance 

• Ensure each office in assigned state(s) are operating within company policy, state licensing regulations and The Joint Commission Standards. 

• Ensure that all staff in assigned state(s) are onboarded within company policy, state licensing regulations and The Joint Commission Standards. 

• Obtain initial facility licenses for Mental Health and Substance Use Disorder Outpatient Treatment 

• Host and organize site visits/surveys/inspections; travel required. 

• Maintain office space compliance for the assigned state(s)