VP, Compliance

Job Responsibilities

• Lead and Evolve the Enterprise Compliance Program.
  • Design, implement, and continuously enhance and mature a comprehensive, data-driven, risk-based Compliance Program aligned with CMS and State requirements, and organizational strategy.
  • Serve as the overall owner of the Compliance Plan and all program documentation, driving annual review and updates to reflect the regulatory landscape and Business growth objectives.
• Provide Strategic Regulatory Guidance to Executive Leadership.
  • Monitor, interpret, and communicate emerging and enacted regulatory and enforcement requirements and trends to the Chief Compliance Officer and senior management.
  • Translate complex regulatory requirements into clear, actionable business strategies, enabling proactive, timely and risk informed decision making across the enterprise.
• Drive Compliance Monitoring, Auditing, and Reporting.
  • Oversee the design and execution of compliance monitoring and auditing plans, ensuring data-driven, actionable insights and executive-level reporting.
  • Establish dashboards and reporting that enable real-time visibility in compliance risk, control effectiveness and program performance.
• Investigations.
  • Direct the investigation of compliance violations and allegations of HIPAA privacy breaches, ensuring they are consistent, defensible and aligned with Alignment and regulatory expectations.
  • Maintain investigation logs and escalation pathways including board-level escalation where appropriate.
• Govern HIPAA Privacy and Data Protection Compliance.
  • Ensure organizational adherence to HIPAA privacy and security rules, including oversight of privacy incident response, breach notifications, and remediation plans.
  • Partner with IT, Legal, and operational leaders to embed data protection standards into business processes and technology platforms.
• Champion Compliance Training and Culture.
  • Oversee compliance education programs ensuring it is strategically aligned, role based and measurable in effectiveness.
  • Promote a culture of accountability, speak-up culture and ethical decision making.
• Compliance Policies.
  • Lead the development, revision, and organization-wide communication of compliance and HIPAA policies, ensuring clarity, legal alignment, and operational usability.
  • Cover coordination with cross-functional partners to integrate compliance requirements into business workflows, contracts, and vendor relationships.

Job Requirements

• Significant MAO Compliance leadership experience (5+ required - 10+ years preferred) interfacing with CMS and State regulators related to audits and enforcement actions as well as internal and external business partners.
• Experience operating within a complex, fast-scaling enterprise health plan or value-based care organization.
• Prior experience directly supporting a Chief Compliance Officer or serving in a #2 Compliance leadership role with Board-level exposure.
• Education Required: Bachelor's degree in Healthcare Administration, Legal Studies, Business, Public Health, or a related field; or equivalent professional experience in lieu of degree.
• Preferred: Advanced degree (or equivalent graduate-level education in a compliance-adjacent discipline).

Specialized Skills

• Data Analytics/Compliance Intelligence
• Enterprise Risk Alignment
• Executive-level communication, engagement and collaboration
• Compliance Management (Advanced)
• Regulatory Compliance (Advanced)
• Health Care Risk Management (Advanced)
• Compliance Reporting (Advanced)
• Health Laws (Advanced)
• Incident Reporting & Investigation (Advanced)
• Ethical Judgment & Integrity (Advanced)

Essential Physical Functions

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pay Range

$227,952.00 - $341,928.00

Disclaimer

Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.