Director, Business Compliance

Summary

Join Aledade's Compliance & Ethics organization as a Business Compliance Director. This critical role utilizes technology-driven solutions to enhance patient outcomes while ensuring compliance with regulations and ethical standards. You will proactively maintain Aledade's adherence to laws, regulations, and internal policies by collaborating with the Legal-Regulatory team. Responsibilities include leading compliance sub-committees, developing compliance programs, providing support for new initiatives, and identifying/mitigating compliance risks. The ideal candidate possesses extensive healthcare compliance experience, a strong understanding of relevant regulations, and excellent communication skills. Aledade offers a comprehensive benefits package including flexible work arrangements, health insurance, paid time off, parental leave, and professional development opportunities.

Requirements

• Bachelor's degree
• 10+ years of work experience, ideally in the healthcare industry
• 7 years of experience in healthcare compliance, and a minimum 5 years of experience in coding and billing compliance
• Strong understanding of healthcare regulations, including HIPAA, Stark Law, Anti-Kickback Statute, and other relevant regulations
• Excellent communication and interpersonal skills, with the ability to present complex information clearly and concisely
• Ability to work independently and as part of a team
• Strong analytical and problem-solving skills

Responsibilities

• Lead the Coding, Risk Stratification, and Billing Compliance Sub-Committee, including an Overpayments Program
• Govern the Practice Partnership Integrity Program
• Develop and implement compliance programs and procedures to ensure compliance with all applicable laws, regulations, and internal policies related to value-based care (Medicare Shared Savings Program and Medicare Advantage)
• Provide compliance support for all new and ongoing programs and business initiatives (e.g., Flex Program, Clinically Integrated Networks)
• Primary compliance point of contact for Product and Technology teams
• Identify and assess compliance risks and develop mitigation strategies
• Provide Compliance training and education
• Stay up-to-date on changes in laws, regulations, and internal policies
• Work closely with other Aledade departments to ensure compliance with all applicable laws, regulations, and internal policies

Preferred Qualifications

• Juris Doctor (JD)
• Certified in Healthcare Compliance
• Experience in value-based care healthcare delivery model
• Experience chairing/leading compliance committees
• Experience presenting and reporting to the Board of Directors

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles
• Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
• Robust time-off plan (21 days of PTO in your first year)
• Two paid volunteer days and 11 paid holidays
• 12 weeks paid parental leave for all new parents
• Six weeks paid sabbatical after six years of service
• Educational Assistant Program and Clinical Employee Reimbursement Program
• 401(k) with up to 4% match
• Stock options