Director Regulatory Compliance

About the role

The Director of Regulatory Compliance is responsible for overseeing compliance, regulatory, audit, and monitoring activities across various lines of business at Nascentia Health. This role supports the Chief Compliance Officer in maintaining an effective compliance program.

Responsibilities

• Oversees day-to-day compliance operations and regulatory oversight activities for MLTC, MAPD/D-SNP, CHHA, LHCSA, Article 28 Clinic programs and other lines of business as applicable.
• Directs operational compliance auditing and monitoring activities to evaluate adherence to federal and state regulations, contractual obligations, internal policies, and accreditation standards.
• Develops and maintains annual compliance work plans, audit schedules, and monitoring activities based on organizational risk assessments.
• Collaborates with operational leadership to develop, implement, and monitor corrective action plans resulting from audits, investigations, surveys, and identified compliance deficiencies.
• Maintains current knowledge of regulatory changes impacting MLTC, MAPD Special Needs Plans, CHHA, LHCSA, and Article 28 operations and ensures operational implementation.
• Provides guidance and support to departmental leaders regarding regulatory interpretation, audit preparedness, and compliance remediation activities.
• Maintains confidentiality and handles sensitive compliance matters with professionalism and discretion.

Requirements

• Bachelor's degree required; Master's degree or Juris Doctor (JD) preferred.
• Minimum of 57 years of healthcare compliance, regulatory, audit, or operational oversight experience required.
• Operational knowledge of CMS, Medicare, Medicaid, NYSDOH, MLTC, MAPD/D-SNP, CHHA, LHCSA, and Article 28 regulatory requirements.
• Experience managing regulatory audits, investigations, corrective action plans, and compliance monitoring programs.
• Certified in Healthcare Compliance (CHC), Certified Professional in Healthcare Quality (CPHQ), or similar certification preferred.
• Strong analytical, auditing, investigative, organizational, and problem-solving skills.
• Excellent written, verbal, and presentation communication skills.
• Ability to interpret complex regulations and apply them operationally across multiple business lines.
• Proficiency in Microsoft Office applications and compliance/audit tracking systems.
• High ethical standards and ability to maintain confidentiality.

Physical Requirements

• Ability to sit/stand 90% of the day
• Speaking/visual/hearing ability sufficient to comprehend and express written/verbal communication
• Frequent sitting, standing, walking
• Extended periods of computer use
• Ability to express self verbally and in writing
• Ability to verbally communicate over the telephone
• Bloodborne Pathogens Exposure Category III - Employee who rarely has contact with blood and body fluids

Compensation & Benefits

• Competitive Salary [This position is an S07 exempt position with a min-max rate of: $108,599 - $135,363/annually]
• Retention Bonuses
• Internal Mentoring Program
• 401K with generous Employer match
• On-Site Gym (free for all employees)
• Medical, Dental, Vision plans
• Tuition Reimbursement
• P业分资助金
• Employee Recognition Platform
• Paid Time Off, Holidays, Sick and Extended Sick Leave
• Short/Long term Disability
• Employee Assistance Program (EAP)
• Much More!

About Nascentia Health

Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.

Nascentia Health is an Equal Opportunity Employer (EOE)

Employment is contingent upon negative results of a pre-hire drug screen and background check clearance.