Director of Compliance Operations & Optimization

C002 Medical University Hospital Authority (MUHA); Town of Charleston (NY); On-site; USD 130,000 - 195,000; Full time

Job summary

Medical University Hospital Authority (MUHA) is seeking a Director of Compliance and Privacy to ensure adherence to federal, state, accreditation, and CMS requirements. You will lead a team across clinical, operational, and administrative areas to promote integrity, readiness, and continuous improvement.

The role focuses on strategic oversight of regulatory risk, development of education programs, and coordination of audits, investigations, and corrective actions, with emphasis on data integrity

Qualifications

• Bachelor’s degree in a healthcare compliance-related field and at least 10 years of relevant experience.
• Or a master’s degree in a healthcare compliance-related field plus 7 years of relevant experience.
• Experience interpreting and operationalizing regulatory requirements related to Provider-Based Regulations, Stark and Anti-kickback Statutes, CMS Conditions of Participation, and related standards.
• CMS First-Tier Downstream and Related Entity Obligations, 340b Drug Pricing Program Provisions, Cost Reporting Compliance, Durable Medical Equipment Requirements, Research Compliance, and Telehealth Regulations.
• Strong leadership, consultative and analytical skills are required.
• Proficient in modern technology platforms and emerging AI capabilities.

Responsibilities

• Ensure communication channels operate effectively to support remediation of compliance concerns from internal reports, the hotline, and exit interviews.
• Conduct targeted research across statutes, rules, and guidance documents to develop compliant, evidence-based advice.
• Monitor, analyze, and interpret regulatory requirements and industry guidance to assess organizational risk and impact.
• Direct the Facility Compliance Liaison Program and expand participation to strengthen local ownership.
• Manage go-live readiness and ongoing compliance for provider-based entities, identifying vulnerabilities and implementing corrective action plans.
• Lead the implementation, administration, and optimization of the compliance performance management system and enterprise case management repository, ensuring data integrity and reporting accuracy.
• Maintain current and aligned written compliance standards including policies, the Code of Conduct, the Compliance Plan, and Annual Report.
• Oversee compliance education program design and governance, including new-hire orientation and annual training modules.
• Assure CMS FDR requirements compliance by monitoring delegated entities and coordinating audits.
• Coordinate with regulatory agencies for external audits, investigations, and self-reporting obligations and drive corrective actions.
• Represent the compliance department on councils, committees, and workgroups to integrate compliance into decision-making.

Skills

Leadership

Analytical skills

Communication skills

Project management

Education

Bachelor's degree in healthcare compliance-related field

Master's degree in healthcare compliance-related field

Job description

Job Description Summary Reporting directly to the Chief Compliance and Privacy Officer, this role helps to ensure the organization meets federal, state, accreditation, and other regulatory requirements. The Director serves as a trusted advisor to the Chief Compliance and Privacy Officer and various committees, and councils as needed, while providing day-to-day oversight of and direction to the Regional Compliance and Privacy Managers. The Director partners with leaders across clinical, operational, and administrative areas to promote a culture of integrity, regulatory readiness, and continuous improvement.

Entity Medical University Hospital Authority (MUHA)

Worker Type Employee Worker Sub-Type Regular

Cost Center CC002278 SYS - Compliance Program Pay Rate Type Salary Pay Grade Health-35 Scheduled Weekly Hours 40 Work Shift

Job Description

• The Director Ensures communication channels operate effectively to support the timely remediation of compliance concerns raised through internal reports, the hotline, and exit interviews.
• Conducts targeted research across statutes, rules, and guidance documents to develop compliant, evidence‑based advice.
• Monitors, analyzes, and interprets regulatory requirements and industry guidance to assess organizational risk and evaluate the impact on business operations and compliance obligations.
• Directs the Facility Compliance Liaison Program by expanding participation to strengthen local compliance ownership.
• Manages go-live readiness and on-going compliance related to provider-based entities, by identifying areas of vulnerability and collaborating with operational leaders to implement corrective action plans.
• Leads the implementation, administration, and ongoing optimization of the compliance performance management system and enterprise compliance case management repository to include assuring data integrity, reporting accuracy and effective system utilization.
• Ensures written compliance standards — including policies, procedures, the Code of Conduct, the Compliance Plan, and Annual Report — remain current, accurate, and aligned with evolving regulatory requirements and program guidance.
• Owns the design, development, and governance of the compliance education program, including new‑hire orientation, annual mandatory training modules, and leadership‑focused communications, while ensuring such materials reflect current regulatory requirements, organizational policies, and risk priorities.
• Assures compliance with Medicare Advantage First Tier, Downstream, and Related Entity (FDR) requirements by monitoring delegated entities, facilitating audits, maintaining documentation, and implementing corrective action plans to meet CMS standards.
• Facilitates non-billing external audits, investigations, and self‑reporting obligations by coordinating with regulatory agencies, preparing audit materials, overseeing evidence collection, managing cross‑functional responses, and ensuring findings are addressed through corrective action plans.
• Represents the compliance department on various organizational councils, committees, and workgroups to ensure compliance considerations are integrated into decision‑making, policy development, and operational planning.

Additional Job Description Requirements (Education, Work Experience, Licensure, Registry & Certifications)

• A bachelor’s degree in a healthcare compliance-related field such as: legal studies, health information management, nursing, public policy, risk management, etc. and at least 10 years of relevant experience.
• Or a master’s degree in a healthcare compliance-related field such as an: MBA, MPA, MHA, JD, MSN, MPH, etc. plus 7 years of relevant experience.
• Experience and/or ability to interpret and operationalize regulatory requirements related to areas such as: Provider-Based Regulations, Stark and Antikickback Statutes, CMS Conditions of Participation, Accreditation Survey Standards, EMTALA Obligations, Conflicts of Interest, Affordable Care Act, Lewis Blackman Act.
• CMS First-Tier Downstream and Related Entity Obligations, 340b Drug Pricing Program Provisions, Cost Reporting Compliance, Durable Medical Equipment Requirements, Research Compliance, Home Infusion Standards.
• Medicare Secondary Payor Requirements, CMS Quality Reporting Programs, Telehealth Regulations, Direct and Indirect Graduate Medical Education (GME) requirements, and Fraud, Waste and Abuse Obligations.
• Strong leadership, consultative and analytical skills are required.
• Must exhibit exceptional interpersonal and communications skills and be able to work independently with minimal supervision.
• Works well in a fast-paced, growing environment that requires adaptability, collaboration, and proactive problem solving.
• Proficient in modern technology platforms and emerging AI capabilities, with the ability to evaluate, adopt, and apply digital tools to improve efficiency, analytics, and program effectiveness.
• CHC, CRMA, CCEP or equivalent preferred.

Physical Requirements

• (Frequent) Ability to perform job functions while standing.
• (Frequent) Ability to perform job functions while sitting.
• (Frequent) Ability to perform job functions while walking.
• (Infrequent) Ability to climb stairs.
• (Continuous) Ability to work indoors.
• (Frequent) Ability to work from elevated areas.
• (Infrequent) Ability to work in confined/cramped spaces.
• (Infrequent) Ability to perform job functions from kneeling positions.
• (Infrequent) Ability to bend at the waist.
• (Frequent) Ability to squat and perform job functions.
• (Infrequent) Ability to perform repetitive motions with hands/wrists/elbows and shoulders.
• (Frequent) Ability to reach in all directions.
• (Frequent) Possess good finger dexterity.
• (Continuous) Ability to fully use both legs.
• (Continuous) Ability to fully use both hands/arms.
• (Continuous) Ability to lift and carry 15 lbs. unassisted.
• (Infrequent) Ability to lift/lower objects 15 lbs. from/to floor from/to 36 inches unassisted.
• (Infrequent) Ability to lift from 36 inches to overhead 15 lbs.
• (Infrequent) Ability to maintain 20/40 vision, corrected, in one eye or with both eyes.
• (Continuous) Ability to see and recognize objects close at hand or at a distance.
• (Continuous) Ability to match or discriminate between colors.
• (Continuous) *(Selected Positions) Ability to determine distance/relationship between objects; depth perception.
• (Continuous) Ability to maintain hearing acuity, with correction.
• (Continuous) Ability to perform gross motor functions with frequent fine motor movements.
• (Continuous) Ability to work in a latex safe environment.
• (Continuous) *Ability to maintain tactile sensory functions.
• (Frequent) *(Selected Positions) *Ability to maintain good olfactory sensory function.
• (Frequent) *(Selected Positions) *If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children’s Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet® designated hospitals in South Carolina.