Senior Director Compliance and Privacy
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Stellar HealthHealth-tech
US-based Health-techFull-TimeDirector
Salary$200K - $240K
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Job Details
- Experience
- 10+ years of experience in healthcare compliance and privacy
- Required Skills
- HIPAA
Requirements
- 10+ years of experience in healthcare compliance and privacy, with progressive responsibility.
- At least 3 years of people management experience.
- Direct, hands-on experience with Anti-Kickback Statute safe harbor analysis, Stark Law, and HIPAA.
- Experience managing compliance across multiple legal entities or business lines simultaneously.
- Direct experience working with or for Medicare Advantage health plans, ACOs, or value-based care organizations.
- Experience responding to government inquiries or investigations (DOJ, OIG, state AG, or OCR).
- Experience with payor or health plan compliance audit processes.
- Familiarity with risk adjustment programs, HCC coding compliance, and CMS enforcement environments.
- Experience conducting or supporting pre-contract compliance reviews for health plan or provider agreements.
- Bachelor's degree or equivalent demonstrated work experience in business, healthcare, or a related field.
Responsibilities
- Implement and monitor compliance program requirements, applicable laws, and customer contracts across all entities.
- Lead pre-contract compliance reviews for new payor and provider agreements to support revenue growth.
- Manage the compliance response process for audits, HIPAA OCR inquiries, state AG investigations, and government enforcement activity.
- Execute annual risk assessments and develop annual work plans and program evaluations.
- Maintain an inventory of regulatory obligations including AKS, Stark Law, HIPAA, CMPL, and CMS requirements.
- Oversee investigations, mitigation activities, and maintain documentation for policies and standards.
- Establish monitoring strategies to detect anomalous user activity within the Stellar platform.
- Manage relationships with external stakeholders, including counsel, regulators, and customer compliance representatives.
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