Chief Compliance Officer
3 days ago
Madison
Pay: $170,000.00 - $180,000.00 per year Job description: Job Summary We are seeking an experienced and strategic Chief Compliance Officer (CCO) to lead our organization is fully compliant and risk management initiatives operationally sound, and proactively protected across all clinical, regulatory, and payer-facing activities. This role is not revenue-owning, but revenue-protective. The CCO works in close partnership with the CFO, COO, and clinical leadership to ensure that billing, coding, documentation, payer strategy, staff operations, and patient-facing processes are legally compliant, audit-ready, and strategically structured. This individual serves as the organization’s first line of defense against regulatory risk, payer disputes, documentation failures, and compliance breakdowns, while enabling ethical, defensible, and scalable growth. The ideal candidate will oversee the development, implementation, and enforcement of compliance policies, ensuring adherence to legal standards and internal procedures. This leadership role requires a proactive approach to managing regulatory requirements, fostering a culture of integrity, and supporting business growth through strategic compliance practices. The CCO will collaborate with senior leadership to align compliance objectives with the organization's overall goals, driving operational excellence and sustainable development. Core Responsibilities Medical & Regulatory Compliance Leadership • Serve as the internal authority on healthcare compliance and regulatory governance, • Ensure compliance with:, • HIPAA / HITECH, • Medicare & Medicaid regulations, • Commercial payer requirements, • State and federal healthcare laws, • Proactively identify compliance risks and implement mitigation strategies before issues arise, • Oversee medical operations compliance across all service lines and providers, • Ensure workflows align with:, • Scope-of-practice laws, • Supervision and delegation requirements, • Documentation and medical necessity standards, • Partner with clinical leadership to support compliant rollout of new procedures, services, and modalities, • Provide governance and oversight of the billing and coding teams, • Ensure accurate and compliant use of:, • CPT, ICD-10, HCPCS codes, • Modifiers and payer-specific rules, • Work with providers to:, • Improve documentation quality, • Align templates and notes with payer and regulatory requirements, • Reduce denials and post-payment risk, • Ensure the organization maintains a buttoned-up, compliant payer strategy, • Oversee governance of:, • In-network billing, • Out-of-network billing, • Hybrid and self-pay workflows, • Ensure compliance with:, • Balance billing rules, • No Surprises Act (NSA), • Fair Health benchmarking (where applicable), • Own and maintain all patient-facing compliance documentation, including:, • HIPAA notices and acknowledgments, • Informed consent forms, • Financial responsibility disclosures, • Medicare/Medicaid-required forms, • Ensure forms are:, • Legally compliant, • Operationally integrated into EMR workflows, • Consistently executed and audited, • Ensure all staff meet compliance requirements related to:, • Licensing and credentialing, • Scope of practice, • HIPAA and privacy, • Internal policies and SOPs, • Oversee compliance components of:, • Staff onboarding, • Annual training, • Attestations and acknowledgments, • Partner with HR and operations on corrective action, retraining, or remediation when compliance gaps arise, • Work collaboratively with:, • CFO (financial governance, payer risk), • COO (operations, workflows, staffing), • Clinical leadership (documentation, care delivery), • Serve as a strategic advisor on compliance implications for growth, expansion, and new service lines, • Translate complex regulations into clear, practical operational guidance, • Lead efforts in risk assessment, mitigation strategies, and process improvements to enhance operational integrity., • Provide strategic guidance on legal and regulatory requirements affecting the organization’s operations., • Oversee internal audits, investigations, and reporting processes related to compliance issues., • Manage relationships with regulatory agencies, external auditors, and legal advisors to ensure ongoing compliance., • Lead training initiatives to promote a culture of ethical behavior and awareness across all levels of the organization., • Monitor changes in laws and regulations impacting the organization and adapt policies accordingly., • 8–12+ years in healthcare compliance, medical operations, billing/coding governance, or regulatory oversight, • Deep experience with:, • Medicare and Medicaid, • Commercial payer compliance, • HIPAA and patient privacy, • Billing and coding oversight, • Demonstrated ability to lead compliance across multi-disciplinary or hybrid practices, • Strong understanding of EMR systems, documentation workflows, and audit preparedness, • Experience supporting audits, payer reviews, or regulatory inquiries, • Certifications such as CHC, CPC, CPMA, CCS, or similar, • You think proactively, not reactively, • You protect the organization by being ahead of regulation and payer behavior, • You can partner with finance and operations without overstepping ownership, • You are respected by providers because you understand how medicine is actually practiced, • You see compliance as a strategic foundation, not a barrier, • Proven experience in management, strategic planning, and operations management within a corporate or organizational setting., • Strong background in senior leadership roles with demonstrated success in negotiation, business development, and project management., • Expertise in process improvement methodologies and implementing effective compliance frameworks., • Excellent leadership skills with the ability to influence cross-functional teams and drive organizational change., • Exceptional communication skills for engaging stakeholders at all levels and presenting complex information clearly., • Bachelor’s degree in Law, Business Administration, or a related field; advanced degrees or certifications, such as CRCM or CCEP, are preferred. This role ensures the organization can grow confidently, operate ethically, and withstand scrutiny from regulators, payers, and auditors. It safeguards patients, providers, and the business by building a culture of compliance, accountability, and operational excellence. Job Type: Full-time Benefits: • 401(k), • Dental insurance, • Employee discount, • Flexible schedule, • Health insurance, • Life insurance, • Paid time off, • Referral program