Compliance Director, Remote

Aledade

Aledade

Legal
Bethesda, MD, USA
Posted on Friday, June 28, 2024
We are looking for a Compliance Director with at least twelve years’ prior experience working in a leadership role in the health care industry, and strong familiarity with regulatory laws and compliance, including fraud, waste and abuse. Our Compliance Director will report directly to Aledade’s Vice President - Compliance and be responsible for assisting and participating in the implementation and operation of Aledade’s Compliance program.
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or from our HQ office in Bethesda, MD (post covid), primarily supporting east coast normal business hours.

Key Responsibilities Include:

  • Serving as a compliance subject matter expert and resource for employees and ACOs, enforcing compliance and the company Code of Conduct across the organization
  • Developing and directing internal compliance initiatives, audit and monitoring activities (e.g., risk assessment, audit work plan development and execution, audit readiness activities, etc.), including development of the annual compliance work plan in alignment with business objectives
  • Directing compliance reporting efforts across multiple business functions by overseeing the evaluation and summary of compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to senior management
  • Directing compliance investigations across multiple business functions by overseeing the collection and analysis of quantitative and qualitative data; conducting interviews on escalated issues as appropriate; reviewing and evaluating research on key business issues; and evaluating and recommending corrective action plans for substantiated allegations
  • Directing programs or compliance components of larger cross-functional programs, such as ACO, Medicare, commercial and Medicaid programs, by identifying and managing stakeholder contacts; developing, analyzing, and managing program plans
  • Directing and overseeing the implementation of compliance efforts by approving compliance requirements; ensuring the assessment of current state compliance to identify gaps and corrective actions; overseeing the analysis and development of complex compliance standards, policies and procedures, and training; and ensuring the monitoring of ongoing compliance adherence
  • Developing and supporting compliance training for Aledade personnel and ACO participants
  • Providing support for Aledade enterprise-wide initiatives, including reviewing proposed business arrangements for possible false claims, Anti-kickback, inducement and other concerns.
  • Providing leadership and direction to ensure alignment between key business functions and Compliance deliverables
  • Building, developing, and maintaining strong business relationships with colleagues on the Compliance Team, Legal Team, and business partners.

Qualifications:

  • Minimum twelve (12) years’ experience in health care compliance, with significant experience leading compliance-related programs
  • Certification in HealthCare Compliance (CHC)
  • Juris Doctorate, with focus on health care law, desirable
  • Substantive knowledge of compliance requirements related to Accountable Care Organizations, Medicare programs (MSSP, Medicare Advantage, REACH, e.g.), and commercial and Medicaid programs
  • Familiarity with risk adjustment regulations and policies, including HCC/diagnosis code accuracy, diagnosis code submission, and Risk Adjustment Data Validation (RADV) Audit
  • Strong written, communication, and research skills
  • Interacts with others in a positive, respectful, and considerate manner. Ability to communicate effectively and professionally. Ability to work in a team environment while also delivering independent results
  • Demonstrated ability to work under competing deadlines and adjust responsibilities in response to recalibrated business needs
  • Ability to be flexible and scale with our extremely fast-paced, thriving startup environment
  • Thinks beyond their immediate team and contributes to making Aledade holistically better (active engagement in D&I efforts, culture initiatives, facilitating training, leading roundtables, etc.)
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays
12 weeks paid Parental Leave for all new parents
6 weeks paid sabbatical after 6 years of service
Educational Assistant Program & Clinical Employee Reimbursement Program
401(K) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
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