Healthcare Compliance Leader – Regulatory Readiness & QA

Five Star Home Health Care LLC; Chantilly (VA); On-site; USD 110,000 - 170,000; Full time

Job summary

Five Star Home Health Care LLC is seeking a compliance leader to manage the agency's comprehensive compliance program from Chantilly, VA. You will ensure alignment with federal regulations, state Virginia home health rules, CMS guidelines, and Joint Commission standards.

You will serve as the primary compliance contact, developing annual monitoring plans, conducting audits across documentation, billing, and PDGM, and coordinating corrective actions with leadership.

Qualifications

• Strong knowledge of healthcare compliance and QA practices.
• Understanding of CMS Conditions of Participation, Virginia home health regulations, and Joint Commission standards.
• Experience with clinical documentation auditing and billing compliance.
• Strong analytical and organizational skills.
• Excellent communication and collaboration abilities.
• Proactive, detail-oriented and able to lead compliance initiatives.

Responsibilities

• Lead and maintain the agency's compliance program, ensuring alignment with federal regulations, Virginia home health requirements, CMS guidelines, and Joint Commission standards.
• Serve as the designated compliance point of contact, promoting accountability across departments.
• Develop and maintain annual compliance monitoring, auditing, and risk assessment plans.
• Oversee regulatory readiness, including mock surveys, tracer activities, and documentation for Joint Commission and Virginia Department of Health visits.
• Conduct routine audits of clinical documentation, OASIS accuracy, plans of care, billing, coding, and PDGM compliance.
• Monitor HHVBP and quality measures alongside the QAPI program, identifying trends and improvement opportunities.
• Coordinate responses to survey findings with corrective action plans and evidence of compliance.
• Monitor regulatory changes and communicate updates to leadership.
• Maintain Code of Conduct and confidential compliance hotline to promote accountability and non-retaliation.
• Partner with Clinical Managers, COO, CCO, and CEO to develop and deliver compliance training.

Skills

Healthcare compliance

Regulatory knowledge

CMS CoPs

Joint Commission

Auditing

Documentation audits

Communication

Analytical skills

Job description

Five Star Home Health Care LLC is seeking a compliance leader to manage the agency's comprehensive compliance program from Chantilly, VA. You will ensure alignment with federal regulations, state Virginia home health rules, CMS guidelines, and Joint Commission standards.

You will serve as the primary compliance contact, developing annual monitoring plans, conducting audits across documentation, billing, and PDGM, and coordinating corrective actions with leadership.