The Compliance Manager provides leadership and oversight of regulatory compliance, quality assurance, clinical documentation, risk management, and operational performance across The Mental Health Collective (MHC) and The Neurodivergent Collective (NDC).
This role ensures full adherence to DSS, DHCS, Title 22, and Title 9 requirements, insurance payer requirements, and professional licensing board standards. The Compliance Manager works closely with HR to ensure staff compliance with California state regulations and maintains accountability across multidisciplinary teams.
The Compliance Manager also leads special projects that improve workflows, patient retention, and service delivery, including advanced clinical programs, and oversees vendor relationships, KPI reporting, audit preparedness, licensing, and credentialing initiatives.
Key Responsibilities:
Department Leadership & Strategic Oversight
- Partner with the Chief Development Officer and Chief Clinical Officer to support organizational strategy, compliance infrastructure, and quality improvement across both MHC and NDC.
- Collaborate with executive leadership and department heads to ensure alignment of compliance initiatives with clinical, operational, and strategic goals.
- Provide leadership in organizational planning, special initiatives, and program expansion.
Regulatory Compliance & Licensing
- Ensure compliance with DSS, DHCS, Title 22, and Title 9 regulations, insurance payer requirements, and professional licensing standards.
- Author and submit Plans of Operation for new and existing programs and facilities.
- Oversee licensing and credentialing applications, renewals, and inspections.
- Maintain professional licensing compliance for all staff (MDs, LVNs, MFTs, PsyDs, LPCCs,)
- Build and maintain relationships with DSS and DHCS auditors, serving as the primary liaison during site visits and audits.
- Collaborate with HR to ensure staff maintain compliance with all California state and Federal HIPAA regulations.
Quality Assurance & Clinical Documentation
- Lead quality assurance programs across both organizations to ensure accuracy, completeness, and regulatory compliance of clinical documentation.
- Oversee the development, maintenance, and optimization of clinical documentation templates, including assessments, progress notes, treatment plans, and discharge summaries.
- Conduct internal audits and create Corrective Action Plans for documentation discrepancies or compliance gaps.
- Develop and monitor KPI reports and analyze patient retention trends to inform organizational improvements.
- Prepare and coordinate responses for regulatory audits, ensuring readiness and accuracy of submissions.
- Analyze audit findings and compliance trends to drive continuous process improvement.
- Manage relationships with compliance and technology vendors, including Circa Compliance, Kipu Compliance, and KIPU Health.
- Lead special projects to improve operational workflows, including transitioning organizational scheduling to electronic systems, significantly enhancing efficiency and staff coordination.
- Evaluate vendor performance and recommend system or process improvements to enhance compliance and operational outcomes.
Program Development & Special Initiatives
- Implement new and oversee existing advanced clinical programs such as SPRAVATO and TMS, ensuring regulatory compliance and operational readiness.
- Assist in opening new residential programs, overseeing all aspects from application, licensing, and regulatory alignment to operational launch.
- Manage and support cross-departmental special projects that enhance organizational efficiency, compliance, and clinical quality.
- Other projects as assigned.
- Conduct investigations into compliance incidents, grievances, or quality issues and Provide recommendations on corrective action for remediation as needed, ensuring executive approval is obtained in conjunction with timely implementation.
- Identify potential organizational risks and develop strategies to mitigate future issues.
Training, CEU Programs & Staff Development
- Develop and facilitate training programs related to compliance, clinical documentation, and regulatory standards.
- Oversee CAMFT-accredited Continuing Education (CEU) events, including planning, documentation, and compliance tracking.
Promote a culture of continuous learning, accountability, and ethical practice throughout the organization.
Qualifications:
- Minimum of 3-5 years of experience in healthcare or behavioral health compliance, quality assurance, or operational leadership.
- Advanced knowledge of Title 22, Title 9, DSS, DHCS, and professional licensing requirements is a plus.
- Expertise in clinical documentation management, Plan of Operation development, licensing and credentialing, and audit preparation.
- Experience managing vendors, CEU programs, KPI reporting, and operational workflow improvements.
- Excellent written and verbal communication skills, with the ability to interact professionally with auditors, staff, and leadership.
- Ability to thrive in a fast-paced environment with displayed competency in managing high pressure deadlines. The role requires calm under pressure and adept ability in utilizing de-escalation techniques. Exceptional interpersonal skills and approachability are essential to be successful in the position.
- Advanced knowledge of and proficiency with technology, including but not limited to Google Suite, AI tools, and basic coding.
- High level of organizational skills, including project management, initiative, and follow-up.
Physical Requirements / Work Environment
- Primarily sedentary office work with occasional lifting of up to 50 pounds.
- Ability to walk, stoop, sit, stand, climb, stretch, and reach as necessary.
- Must have adequate hearing (with or without accommodation) for frequent communication with clients, staff, and agencies.
- May involve exposure to unpredictable situations related to client behavior.
Work Location:
This position is based primarily on-site in Newport Beach, CA, Monday through Friday, with some flexibility available.