Associate Director of Compliance & Quality Improvement

About the role

TheAssociate Director of Compliance & Quality Improvementis a key leadership role responsible for designing implementing and managing a comprehensive compliance program across the behavioral health system. Reporting directly to theDirector of Clinical Operations & Network Strategy this position ensures that all organizational activities clinical operations and business practices adhere to federal state and payer regulations internal policies and ethical standards.

The Associate Director will establish and lead the compliance infrastructuredeveloping systems policies and processes that minimize organizational risk ensure readiness for audits and drive quality improvement. The role will require close collaboration with departments includingPayer Relations Provider Relations Practice Management Quality Human Resources Clinical Operations Finance and othersto ensure a culture of compliance and accountability across the enterprise.

What youll do

• Compliance Program Leadership
• Design implement and oversee the organizationsCompliance Department and comprehensive compliance program ensuring alignment with regulatory requirements accreditation standards and organizational goals.
• Develop update and enforce compliance policies and procedures covering clinical operational billing privacy and administrative activities.
• Establish mechanisms forreporting investigating and resolving compliance concerns ensuring timely and appropriate corrective actions and performance improvement projects.
• Create and maintain acompliance governance structure that includes regular reporting to the leadership teams in conjunction with the Director of Clinical/Medical Operations & Network Strategy & Development which provides compliance forecasting on a continuous basis
• Monitor regulatory developments in behavioral health and ensure timely communication and implementation of necessary changes.

Regulatory Oversight & Risk Management

• Oversee compliance with all applicable federal and state regulations including HIPAA CMS Medicaid Medicare CARF and other/payer-specific standards as needed
• Develop arisk assessment frameworkto identify prioritize and mitigate potential areas of compliance vulnerability.
• Conduct and manageinternal audits and monitoring activitiesto ensure accuracy and integrity in billing documentation clinical operations and administrative practices.
• Lead investigations into compliance violations coordinate corrective actions and ensure follow-up and documentation.
• Serve as the organizational liaison for external audits payer reviews and regulatory inspections.
• Prepare comprehensive compliance reports and risk analyses for executive leadership.

Program Management & Quality Initiatives

• Establish and manage a structuredCompliance Program Management Office (PMO)for overseeing ongoing and ad hoc compliance and quality improvement initiatives.
• Plan lead and trackorganization-wide projectsfocused on audit readiness quality improvement and risk reduction.
• Collaborate with Clinical and Operations leadership to align quality and compliance initiatives with performance improvement goals.
• Implement data-driven compliance dashboards and tracking systems for real-time visibility into key compliance indicators.
• Partner with the Quality and Clinical Operations teams to ensure performance improvement activities support regulatory compliance and best practices.

Collaboration & Cross-Functional Engagement

• With the collaboration of the Director Clinical/Medical Operations & Network Strategy & Development work in close partnership with:
• • Payer Relationsto ensure adherence to payer contract requirements credentialing standards and utilization review expectations.
  • Provider Relationsto reinforce provider education training and compliance with documentation coding and clinical protocols.
  • Practice Managementto maintain compliant workflows patient privacy standards and operational efficiency.
  • Human Resourcesto manage compliance training programs employee onboarding education and disciplinary processes when appropriate.
  • Finance & Billing Teamsto ensure claims integrity and compliance with reimbursement requirements.
• Serve as a trusted compliance advisor to operational leaders ensuring integration of compliance considerations in all decision-making processes.

Training Education & Culture

• Develop and implement acomprehensive compliance training and education programfor staff and leadership at all levels.
• Promote a proactive culture of compliance ethics and transparency throughout the organization.
• Provide ongoing guidance and mentorship to department leaders to strengthen internal accountability and compliance ownership.

Qualifications

Education:Bachelors and/or Masters degree in Healthcare Administration or related field preferred but not required if equivalent experience standards are met

Required Experience:

• • Minimum4 - 5 years of experiencein healthcare compliance preferably within behavioral health mental health or integrated care systems.
  • Demonstrated experiencebuilding and leading compliance programsor departments.
  • Strong background inpayer compliance audits and risk mitigation.
  • Knowledge of federal and state healthcare regulations including HIPAA CMS OIG and behavioral health licensing standards.
• Certifications (Preferred):
• • Certified in Healthcare Compliance (CHC) or Certified Professional Compliance Officer (CPCO) or willingness to obtain certification within one year of employment
• Skills & Competencies:
• • Proven ability to manage complex compliance initiatives and cross-departmental collaboration.
  • Strong analytical investigative and project management skills.
  • Exceptional written and verbal communication skills for training policy development and leadership reporting.
  • Strategic thinker with the ability to operationalize compliance frameworks into scalable systems.

Reports To: Director of Clinical Operations & Network Strategy

Work Environment & Travel:

• Hybrid or on-site role depending on organizational needs.
• Moderate travel to clinics regional offices or audit sites as needed.

Schedule

• Full-Time 40 hours per week Monday-Friday 9-5pm

What we offer:

Casa Esperanza Benefits Package:

• Holiday Pay (12 days per year 1 floating holiday)
• Paid Time Off (PTO) - 18 days year one 20.5 days at year 2 23 days at year 5
• Sick Pay - 10 paid days per year
• Long/ShortTerm Disability
• Paid by Company Life Insurance
• Health Insurance (Medical Dental Vision)
• Health Reimbursement Arrangement (HRA)
• FSA/DCA (Flexible Spending Account & Dependent Care)
• ComPsych Guidance Resources - EAP
• Educational Opportunities
• Tuition Remission
• Employee Ticket at Work (Discounts for Entertainment travel movies; etc.)
• Career Advancement Opportunities
• Increased Salary for Credentials
• and more....

Physical & Mental Requirements

While performing the duties of this job the employee is regularly required to walk stoop kneel crouch or crawl and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include distance vision peripheral vision and depth perception.

At Casa Esperanza Inc. the health and safety of our people is our number one priority. Thats why all offers of employment are contingent on the candidate showing proof of being fully vaccinated against COVID-19 (currently one dose of the Johnson & Johnson vaccine or two doses of the Pfizer or Moderna vaccine and boosted when eligible) to pass the pre-employment requirements. Individuals with medical issues or religious beliefs that prevent them from getting the vaccine may request an exemption from the vaccine requirement.

Casa Esperanzas EEO Statement

Casa Esperanza Inc. values its diverse workplace and encourages women people of color LGBTQIA individuals people with disabilities members of ethnic minorities foreign-born residents older members of society and others from minority groups and diverse backgrounds to apply.

We recruit hire employ train promote and compensate individuals based on job-related qualifications and abilities. Casa Esperanza Inc. also has a longstanding policy of providing a work environment that respects the dignity and worth of each individual and is free from all forms of employment discrimination including harassment because of race color sex gender age religion or religious creed national origin ancestry citizenship marital status sexual orientation gender identity gender expression genetic information physical or mental disability military or veteran status or any other characteristic protected by law. All employees interns volunteers and contractors of Casa Esperanza Inc. are responsible for maintaining a work culture free from discrimination and harassment by treating others with kindness and respect.

Casa Esperanza Inc. also provides reasonable accommodation to qualified individuals with disabilities or based on a sincerely held religious belief in accordance with applicable laws. If you need to inquire about an accommodation or need assistance with completing the application process please email.

Required Experience:

Director