Compliance Officer - Fully Remote

Multi-State Management Services Organization (MSO)

Position Summary

The Compliance Officer is responsible for the development, implementation, and oversight of the organization’s enterprise-wide compliance program across a multi-state MSO supporting physician practices, ambulatory surgery centers (ASCs), and clinical laboratory services. This role ensures adherence to federal and state regulatory requirements, payer contracts, accreditation standards, and internal policies.

The Compliance Officer serves as the primary resource for regulatory interpretation, risk mitigation, internal auditing, compliance education, and enforcement of ethical standards across all service lines.

Reporting Structure

• Reports to: Chief Executive Officer 
• Works closely with: COO, VP of Operations, CFO, Revenue Cycle Leadership, Clinical Leadership, HR, IT, and Practice Administrators

Key Responsibilities

1. Enterprise Compliance Program Management

• Develop, implement, and maintain a comprehensive compliance program consistent with OIG guidelines
• Conduct annual compliance risk assessments across physician practices, ASCs, and laboratories
• Develop and maintain policies and procedures aligned with federal and state laws
• Ensure compliance program effectiveness across all states of operation

2. Regulatory Oversight & Interpretation

• Monitor compliance with applicable federal and state regulations, including:
  • HIPAA and HITECH
  • Stark Law
  • Anti-Kickback Statute
  • False Claims Act
  • CMS Conditions of Participation (ASC and laboratory)
  • CLIA regulations
  • OSHA requirements
  • State Department of Health regulations
  • Payer contract compliance
• Provide regulatory interpretation and guidance to executive and operational leadership

3. Audit & Monitoring

• Develop and oversee internal auditing and monitoring programs
• Coordinate coding, billing, and documentation audits
• Review revenue cycle workflows for regulatory risk
• Oversee laboratory compliance audits (CLIA, proficiency testing, validation processes)
• Coordinate external audits and regulatory surveys
• Track corrective action plans and ensure timely resolution

4. ASC & Laboratory Regulatory Compliance

• Ensure compliance with CMS Conditions for Coverage for ASCs
• Oversee accreditation readiness (AAAASF, AAAHC, Joint Commission as applicable)
• Monitor laboratory compliance under CLIA regulations
• Coordinate mock surveys and regulatory preparedness initiatives

5. Investigations & Risk Management

• Oversee compliance hotline and reporting mechanisms
• Conduct internal investigations related to fraud, waste, abuse, or regulatory concerns
• Maintain documentation of investigations and resolutions
• Report significant compliance matters to executive leadership and Board as appropriate
• Recommend corrective actions and disciplinary measures when necessary

6. Education & Training

• Develop and deploy annual compliance training programs
• Provide targeted training on regulatory updates and identified risk areas
• Educate leadership and staff on documentation integrity and billing compliance
• Ensure training completion tracking across all locations

7. Data Privacy & Security Oversight

• Collaborate with IT leadership to ensure HIPAA compliance
• Oversee breach investigation and reporting processes
• Ensure Business Associate Agreements are maintained and compliant
• Monitor data governance and PHI security protocols

8. Policy Development & Governance

• Draft and update enterprise compliance policies
• Standardize compliance documentation across all entities
• Participate in contract review processes to assess regulatory risk
• Ensure governance structure supports regulatory oversight

9. Board & Executive Reporting

• Provide quarterly compliance reports to executive leadership and Board
• Present risk assessments, audit findings, and mitigation strategies
• Advise leadership on regulatory exposure and enterprise risk

Required Qualifications

• Bachelor’s degree required; Master’s degree preferred (Healthcare Administration, Law, Compliance, or related field)
• Minimum 5–7 years of healthcare compliance experience
• Multi-state healthcare experience strongly preferred
• Experience supporting physician practices, ASC, and laboratory environments
• Certification preferred:
  • Certified in Healthcare Compliance (CHC)
  • Certified Professional Compliance Officer (CPCO)
• Strong knowledge of CMS, OIG, CLIA, and state healthcare regulations

Competencies

• Strong regulatory interpretation skills
• High integrity and ethical judgment
• Executive-level communication ability
• Investigative and analytical capability
• Process-oriented and detail-focused
• Ability to work cross-functionally in a matrixed MSO structure
• Comfortable operating in growth-oriented, acquisition-driven environments

Work Environment

• Multi-site, multi-state oversight
• Hybrid or remote with travel to practices, ASCs, and labs as needed
• Periodic regulatory survey and audit support

Performance Metrics

• Completion of annual risk assessments
• Audit closure timelines
• Reduction in compliance-related findings
• Training completion rates
• Regulatory survey outcomes
• Timely investigation resolution

 Required Qualifications

• Bachelor’s degree required; Master’s degree preferred (Healthcare Administration, Law, Compliance, or related field)
• Minimum 5–7 years of healthcare compliance experience
• Multi-state healthcare experience strongly preferred
• Experience supporting physician practices, ASC, and laboratory environments
• Certification preferred:
  • Certified in Healthcare Compliance (CHC)
  • Certified Professional Compliance Officer (CPCO)
• Strong knowledge of CMS, OIG, CLIA, and state healthcare regulations