Director of Compliance

Universal Health Services; Reno (NV); On-site; USD 110,000 - 165,000; Full time

Job summary

Prominence Health, a value-based care organization under Universal Health Services, seeks a senior compliance leader to direct efforts safeguarding Medicare and commercial programs. You will align policies, coordinate audits, and drive regulatory adherence across the organization.

This role requires deep knowledge of healthcare regulations, strong leadership, and the ability to communicate complex requirements to diverse teams and regulators.

Qualifications

• 7-10 years of healthcare compliance, regulatory affairs, government programs, or managed care experience.
• Minimum 3 years leadership experience.
• Experience with Medicare Advantage and CMS audits, CAPs, accreditation reviews.
• Preferred certifications: CHC, CHPC, CRCM.
• Excellent organizational, judgment and analytical skills; strong written and verbal communication.

Responsibilities

• Direct and coordinate Prominence’s efforts to ensure compliance with laws, regulations, and policies governing Medicare and commercial business.
• Develop and implement compliance programs, policies, and procedures across the organization.
• Lead CMS audits, CAPs, accreditation reviews, and respond to regulatory inquiries.

Skills

Healthcare compliance

Regulatory affairs

Leadership

Communication

Education

Bachelor’s degree

CHC/CHPC/CRCM certifications

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary

Direct and coordinate Prominence’s efforts to ensure compliance with laws, regulations, and policies that govern its Medicare, and commercial business

Benefit Highlights

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications and Requirements

• Bachelor’s degree
• 7-10 years of healthcare compliance, regulatory affairs, government programs, or managed care experience.
• Minimum 3 years leadership experience.
• Experience with Medicare Advantage preferred.
• Experience managing CMS audits, CAPs, accreditation reviews, or insurance department examinations strongly preferred.
• Previous state or federal regulatory or managed care compliance experience preferred.
• Preferred Certifications: CHC, CHPC, CRCM
• Excellent organizational, judgment and analytical skills. Ability to work well both independently and with others in a matrix environment.
• Strong influencing skills and perseverance in investigating.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, governmental regulations, and legal documents. Excellent oral and written communication skills. Ability to write clear, concise reports, business correspondence, and procedures.
• Ability to effectively present and represent the plan’s interests externally with regulators.
• Ability to effectively present information and respond to inquiries from employees, regulatory agencies, and other, as necessary.
• Ability to initiate administrative activities as necessary, and institute quality control procedures.
• Ability to meet deadlines and adjust to changes in company policies, procedures, and priorities.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.