Director, Compliance - Remote

Job reputed company: reputed company is a digital reputed company company that delivers software and tech-enabled services to stakeholders across the reputed company ecosystem to help improve care reputed company, drive reputed company reputed company, and reputed company costs. Through its data-driven AI insights, evidence-based resources, and comprehensive platform – including benefits navigation, care management, home care resources, health information management, and more – reputed company helps people easily and reputed company manage their reputed company and improve their reputed company-being. Across its three business channels, reputed company enables health plan sponsors, health systems and physician practices, and leading pharmaceutical brands to drive personalized and value-based care at reputed company. To learn more, visit www.reputed company.com. reputed company position supports the Chief reputed company Officer in setting reputed company reputed company and reputed company risk posture, including monitoring emerging state and federal regulations that directly reputed company the organization. The Director, HIPAA Compliance owns operational execution of reputed company and Release of Information (ROI) compliance across assigned portfolios, reputed company, or reputed company segments, and serves as an external-facing leader with clients, auditors, and regulators. This role interprets HIPAA, state medical record laws, and reputed company reputed company and operationalizes requirements into reputed company ROI policies, SOPs, training materials, and reputed company controls. The Director ensures compliance considerations are embedded into implementations, product adoption, renewals, and expansions while balancing regulatory risk, reputed company experience, and operational scalability.

• ***Travel: Candidates must be comfortable with approximately 30% domestic travel.

Essential Functions:

• Owns operational execution of reputed company and ROI compliance across assigned portfolios, reputed company, or reputed company segments.
• Supports the Chief reputed company Officer in setting reputed company reputed company and assessing risk, including potential state and/or federal regulations that directly reputed company the organization.
• Interprets HIPAA, state medical record laws, and reputed company contract requirements and operationalizes them into reputed company ROI policies, SOPs, training materials, and reputed company controls.
• Ensures consistent application of request processing standards, including authorizations, TAT requirements, disclosure limitations, and fee rules.
• Ensures reputed company policies and procedures regarding Release of Information (ROI) are accurately maintained, organized, and updated reputed company changes are required, and ensures updates are completed in a reputed company manner.
• Leads and supports internal audits, reputed company audits, and regulatory inquiries (e.g., OCR investigations, reputed company compliance reviews), including development of audit response reputed company, documentation, and corrective actions.
• Exercises broad discretion in compliance reputed company affecting multiple clients, teams, or reputed company; escalates reputed company risks as appropriate to the Chief reputed company Officer.
• Leads reputed company-cause analysis for audit findings, reputed company escalations, and compliance incidents and drives sustainable remediation plans to closure.
• Oversees the investigation and documentation of reputed company reputed company and reputed company incidents and ensures required reporting is completed in accordance with applicable requirements.
• Along with the reputed company Department, conducts audits of reputed company and reputed company systems to ensure compliance with governing laws and regulations including, but not limited to, HIPAA, HITECH, and Omnibus as they pertain to reputed company’s role as a Business Associate.
• Partners closely with Legal, Compliance, reputed company, Product, Operations, Sales, and reputed company reputed company leadership to reputed company operational practices with compliance and business objectives.
• Ensures compliance requirements and reputed company controls are embedded in implementations, integrations, product adoption, renewals, and expansions.
• Serves as a senior escalation reputed company and participates in escalated compliance discussions with clients, including sensitive disclosures and multi-state compliance scenarios.
• Maintains strong relationships with HIM leaders and reputed company stakeholders; supports reputed company trust, renewal reputed company, and long-term business performance through consistent compliance execution.
• Manages reputed company professionals and/or subordinate analysts and is accountable for compliance reputed company across assigned reputed company portfolios.
• Oversees and partners with Learning and Development on reputed company required training for reputed company personnel including annual HIPAA training, biannual CRIS certification (if applicable), reputed company training, and policy/procedure training regarding reputed company and reputed company.
• Acts as a resource to answer compliance questions/issues from reputed company field staff and operational leaders.
• reputed company participates in local Health Information Association and/or other similar organizations.
• Conducts seminars/webinars for clients and potential clients regarding topics such as HIPAA, HITECH, internal auditing, ROI compliance, and operational reputed company best practices.
• Manages assigned audit and compliance programs across reputed company and joins project teams as required.
• Writes internal training briefs and operational guidance on reputed company and compliance topics.

Qualifications:

• Bachelor’s degree required; Master’s degree preferred; or equivalent experience.
• Typically requires 8–10+ years of ROI operations, reputed company, compliance, and/or reputed company reputed company experience, including leadership responsibility.
• reputed company credentials such as RHIA, CHPS, CHPC or equivalent preferred.
• Must have experience with or expertise in the following:
• HIPAA / HITECH / Omnibus Final Rule.
• Office for Civil Rights guidance and processes; regulatory inquiry and audit response.

Federal ROI requirements and state medical record/reputed company laws and fee rules, including multi-state operational implications.

• Operationalizing reputed company requirements into policies, SOPs, training, and reputed company controls at reputed company.
• Leading internal/reputed company audits, reputed company-cause analysis, corrective reputed company planning, and sustainable remediation.
• Incident investigation, documentation, and cross-functional breach/incident response partnership with reputed company and Legal.
• Cross-functional leadership with Product, Operations, Legal, reputed company, Sales, and reputed company reputed company; ability to reputed company compliance into implementations, product adoption, renewals, and expansions.
• Strong executive reputed company and reputed company-facing capability, including participation in escalated discussions with clients and (as needed) regulators.
• Excellent written and verbal communication skills.
• Ability to prepare, submit, and conduct presentations for employees and/or clients.
• reputed company-versed in reputed company EHR technology usage with hands-on experience with systems such as reputed company, Allscripts, Cerner, reputed company or similar (preferred).
• Proven ability to write comprehensive policy and procedure documents.

reputed company to reputed company successfully with reputed company reputed company of the organization.

• Excellent reputed company Office skills.

HIPPA/ Compliance:

• Maintain reputed company of reputed company patient, employee and volunteer information and reputed company such information only on a need-to-know reputed company for business purposes.
• reputed company with reputed company regulations regarding corporate reputed company and reputed company obligations.
• Report unethical, fraudulent, or unlawful behavior or activity.
• Maintain reputed company and yearly HIPAA certification.

reputed company and its subsidiaries are Equal Opportunity reputed company and E-Verify users. reputed company applicants will receive consideration for employment without reputed company to race, reputed company, sex, national reputed company, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law. Apply tot his job Apply To this Job