Compliance & Integrity Director
Core
Design, implement, and maintain a risk-based audit and monitoring program for a primary care provider, focusing on coding audit oversight, risk adjustment, revenue integrity, and HIPAA privacy/security.
Role type
Director of Compliance & Integrity (Healthcare)
Builds
Enterprise-scale compliance infrastructure and audit functions for a rapidly expanding primary care network.
Domain
Healthcare / Regulatory Compliance / Risk Management
Deliverable
production ML models | dashboards & analysis | client delivery
Required skills
Healthcare compliance expertise, risk-based audit program design, HIPAA privacy/security knowledge, Medicare Advantage compliance, risk adjustment, value-based care regulatory programs, leadership, cross-functional collaboration, data analytics, AI tool integration
Preferred skills
Enterprise-scale compliance program scaling, AI-assisted audit tools, data analytics platforms, attorney-led assessments, healthcare compliance technology
Technologies
Microsoft Office Suite, audit management software, GRC systems, AI tools, data analytics platforms
Responsibilities
Design and execute risk-based annual audit work plans; lead and develop the Coding Audit team; conduct periodic audits of privacy and security practices; prepare audit reports and present findings to senior leadership; drive corrective actions and compliance training; integrate AI and analytics to enhance audit efficiency.
Seniority
Director, strategic leadership & program ownership
