Compliance & Integrity Director

ChenMed; United States; On-site; USD 150,000 - 195,000; Full time

Job summary

ChenMed in the United States is seeking a Director of Compliance & Integrity to lead the design, implementation, and oversight of ChenMed's audit and monitoring program focused on risk adjustment, growth and revenue integrity, and HIPAA privacy & security. This role partners with Compliance leadership to address regulatory changes and scale the function.

The ideal candidate brings deep healthcare compliance expertise, proven leadership, and a track record of building compliance infrastructure

Qualifications

• Deep expertise in healthcare compliance, audit, and regulatory risk management.
• Experience designing and scaling risk-based audit and monitoring programs.
• Strong analytical, problem-solving, and leadership skills.
• Ability to communicate complex findings to executives and clinicians.
• Willingness to travel up to 25% and work across departments.

Responsibilities

• Designs and maintains a structured audit and monitoring program for value-based care.
• Conducts privacy and security audits and remediates PHI vulnerabilities.
• Prepares audit reports and presents findings to leadership and stakeholders.
• Leads and develops the Coding Audit team and ensures ongoing training.
• Leads continuous improvement by integrating AI and analytics into audits.

Skills

Leadership

Regulatory risk management

Audit program design

Data analytics

HIPAA privacy & security

Communication

Cross-functional collaboration

Tools

Excel

PowerPoint

GRC software

Data analytics tools

Job description

We're unique. You should be, too.We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

Director of Compliance & Integrity (Compliance Oversight and Audit)

This is a key leadership role responsible for designing, implementing, and maintaining ChenMed's audit and monitoring program-with a focus on coding audit oversight and risk-based compliance monitoring-and for driving compliance efforts across key risk areas, including risk adjustment, growth and revenue integrity, and HIPAA privacy & security. This position collaborates with the Compliance leadership to monitor and respond to emerging regulatory developments affecting the organization. This role will also strategize the integration of artificial intelligence and advanced analytics tools to modernize and scale audit functions. The ideal candidate combines deep expertise in healthcare compliance with leadership capability, experience overseeing compliance audits, intellectual curiosity about new technology, and a commitment to ChenMed's Purpose: the urgent pursuit of more good days.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES

• Audit & Monitoring Program Design and MaintenanceDesigns, implements, and maintains a structured audit and monitoring program specific to ChenMed's value-based care model, aligned with CMS requirements, OIG guidance, and applicable federal and state regulations encompassing Risk Adjustment Data Validation (RADV), Medicare Communications & Marketing Guidelines (MCMG), HIPAA Privacy and Security, and other risk areas.Develops and executes a risk-based annual audit work plan.Leads, expands and oversees the Coding Audit team and professional development.Prepares to transition to strategic direction as the function scales while maintaining accountability for audit outcomes.
• HIPAA Privacy and Security ComplianceConducts periodic audits of privacy and security practices, policies, and controls.Collaborates with IT, Information Security, Operations, and Legal to identify and remediate potential vulnerabilities related to protected health information (PHI).Assists the Compliance & Privacy Officer in breach risk assessments and response activities, as needed.
• Reporting, Collaboration & Continuous ImprovementMaintains accurate documentation and prepares clear, actionable audit reports and presents findings to the Compliance leadership, senior leadership, and relevant stakeholders.Collaborates cross-functionally to drive corrective action, conduct compliance gap analyses, and delivers training programs ensuring staff understand regulatory requirements and compliance obligations.Champions the integration of artificial intelligence and data analytics tools to enhance audit efficiency, accuracy, and scope, building team competency in the use of emerging audit technologies, ensuring staff are prepared to work in an increasingly data-driven environment.
• Performs other duties as assigned and modified at manager's discretion.

KNOWLEDGE, SKILLS AND ABILITIES

• Expert-level business acuity with advanced understanding of healthcare compliance, audit, and regulatory risk management frameworks.
• Demonstrated ability to design and operationalize risk-based audit and monitoring programs in a complex healthcare organization; experience building compliance infrastructure from the ground up, scaling programs during growth, or transforming inherited frameworks.
• Strong analytical, critical thinking, and problem-solving skills.
• Proven leadership ability.
• Excellent written and verbal communication skills, including the ability to present complex findings clearly to executive and clinical audiences.
• High ethical standards, integrity, and the professional courage to raise concerns and enforce standards consistently; demonstrated commitment to operating with accountability.
• Alignment with ChenMed's Core Values of Love, Accountability, and Passion; demonstrated ability to build and lead teams with integrity, hold others accountable to high standards, and drive toward organizational objectives with genuine care for outcomes and people.
• Ability to build collaborative relationships across departments and influence without direct authority.
• Advanced skill in Microsoft Office Suite products including Excel, Word, PowerPoint, and Outlook; competent in audit management software or GRC systems preferred.
• Ability and willingness to travel locally, regionally, and/or nationally up to 25% of the time.
• Spoken and written fluency in English.
• This job requires use and exercise of independent judgment.

Additional knowledge that strengthens candidacy

• Comprehensive understanding of HIPAA Privacy and Security Rules, MCMG requirements, and federal healthcare fraud, waste, and abuse laws (Anti-Kickback St