Director of Compliance and Delegation Oversight

About the Role

The Director of Compliance and Delegation Oversight leads COPE Health Solutions’ (CHS) enterprise compliance and delegation oversight activities across CHS corporate operations, affiliated and risk-bearing entities, and client engagements. The role ensures that CHS and the organizations it oversees operate in accordance with applicable federal and state requirements, contractual obligations, accreditation standards, program requirements, and internal policies.

Responsibilities

• Lead CHS’s enterprise compliance and delegation oversight program, including strategy, risk assessment, policies, procedures, standards, monitoring, reporting, training, and continuous improvement.
• Establish an oversight approach that reflects CHS’s role in each arrangement, including as a delegating entity, delegated entity, downstream contractor, business associate, vendor, risk-bearing provider organization, ACO operator or participant, TPA, MSO, or healthcare consultant.
• Provide compliance leadership across CHS entities, solutions, and client engagements, including CHS IPA, CHS RKK, CHS LEAD, MSSP ACO activities, TPA and MSO engagements, ARC clients, and other healthcare consulting clients.
• Maintain a risk-based framework for pre-delegation assessments, onboarding, due diligence, readiness reviews, ongoing monitoring, periodic reevaluation, audits, corrective action, and escalation when CHS is the delegating entity.
• Lead readiness for health plan, payer, client, regulator, and accreditation oversight when CHS is the delegated or contracted entity; coordinate responses to audits and information requests; track contractual and regulatory deliverables; and oversee remediation of identified deficiencies.
• Evaluate prospective and existing relationships to determine compliance obligations and document whether activities should be treated as delegation, subcontracting, vendor oversight, business associate services, consulting services, or internal operations.
• Monitor performance against contractual requirements, regulatory and program obligations, service levels, quality standards, reporting commitments, and internal expectations.
• Lead or coordinate audits and monitoring activities, including audit planning, document requests, file review, interviews, scoring, findings, exit conferences, corrective action plans, validation reviews, and follow-up.
• Review and trend compliance and operational data, including performance metrics, timeliness indicators, audit results, corrective action items, complaints, incidents, and escalation events.
• Manage corrective action plans, remediation timelines, validation reviews, and escalate when performance or compliance issues are not corrected within required timeframes.
• Recommend suspension, limitation, or termination of delegation, subcontracting, vendor, or client arrangements when risk cannot be adequately mitigated.
• Serve as CHS’s subject-matter expert for Business Associate Agreements (BAAs), leading review, redlining, negotiation, implementation, and lifecycle management of BAAs and related healthcare privacy and data-sharing provisions.
• Develop and maintain BAA templates, playbooks, fallback positions, approval thresholds, and escalation protocols; escalate novel or high-risk provisions to executive leadership and/or legal counsel.
• Advise business leaders on practical implementation of BAA obligations, including permitted uses and disclosures, subcontractor requirements, incident notification, audit rights, and termination provisions.
• Support compliance for value-based care arrangements, including governance, provider oversight, reporting, audit readiness, and remediation obligations.
• Design compliance approaches for consulting clients based on each client’s legal structure, services, risk profile, contracts, and regulatory environment.
• Prepare and present compliance reports, dashboards, risk assessments, and issue summaries for senior leadership, governance committees, clients, auditors, and regulators.
• Partner with cross-functional teams to ensure compliance requirements are operationalized and monitored.
• Maintain records of agreements, oversight schedules, audit tools, findings, corrective actions, and termination recommendations.
• Support regulatory examinations, accreditation surveys, client audits, and internal/external audit responses.
• Develop and deliver training on compliance, delegation, BAA, documentation, and reporting requirements.
• Review and recommend improvements to compliance policies, processes, and workflow controls.

Qualifications

The position requires expertise in healthcare compliance, delegation oversight, and Business Associate Agreements (BAAs), with a deep understanding of federal and state regulations, accreditation standards, and value-based care models. The Director must possess strong leadership, analytical, and communication skills, with the ability to manage complex compliance programs and collaborate across diverse teams.

Benefits

As a firm passionate about health care, we’re deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, a yearly stipend for wellness-related activities, and a paid parental leave program. Learn more about our benefits offerings here.

About COPE Health Solutions

COPE Health Solutions is a national tech-enabled services firm powering success for health plans and providers in risk arrangements. Our NCQA-certified population health management platform and experienced team improve financial performance and quality outcomes for payers and providers. CHS de-risks the roadmap to advanced value-based payment and enhances performance for providers, health plans, and self-insured employers. Learn more about us here.

FLSA Status: Exempt
Salary Range: $172,100 - $218,200
Reports To: Principal and SVP, Operations
Direct Reports: Yes
Location: Hybrid in LA Office
Travel: Up to 10%
Work Type: Regular
Schedule: Full Time