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Medical University of South Carolina

Health sciences university in Charleston, SC

Director of Compliance Operations & Optimization

Regulatory Compliance & EthicsConfirmed live in the last 24 hours
Full-timeCharleston, SC, USANo salary listedIn-person

About the Job

Requirements

  • A bachelor's degree in a healthcare compliance-related field such as legal studies, health information management, nursing, public policy, or risk management, 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, or MPH, plus 7 years of relevant experience.
  • Experience and/or ability to interpret and operationalize regulatory requirements related to Provider-Based Regulations, Stark and Antikickback Statutes, CMS Conditions of Participation, Accreditation Survey Standards, EMTALA Obligations, Conflicts of Interest, the Affordable Care Act, and the Lewis Blackman Act.
  • Experience and/or ability to interpret and operationalize regulatory requirements related to CMS First-Tier Downstream and Related Entity Obligations, 340b Drug Pricing Program Provisions, Cost Reporting Compliance, Durable Medical Equipment Requirements, Research Compliance, and Home Infusion Standards.
  • Experience and/or ability to interpret and operationalize regulatory requirements related to Medicare Secondary Payor Requirements, CMS Quality Reporting Programs, Telehealth Regulations, Direct and Indirect Graduate Medical Education requirements, and Fraud, Waste and Abuse Obligations.
  • Strong leadership, consultative, and analytical skills.
  • Exceptional interpersonal and communication skills, and the ability to work independently with minimal supervision.
  • Proficiency with modern technology platforms and emerging artificial intelligence capabilities, including the ability to evaluate, adopt, and apply digital tools to improve efficiency, analytics, and program effectiveness.

Responsibilities

  • Ensure communication channels support timely remediation of compliance concerns raised through 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 evaluate impacts on business operations and compliance obligations.
  • Direct the Facility Compliance Liaison Program and expand participation to strengthen local compliance ownership.
  • Manage go-live readiness and ongoing compliance for provider-based entities by identifying vulnerabilities and collaborating with operational leaders on corrective action plans.
  • Lead implementation, administration, and ongoing optimization of the compliance performance management system and enterprise compliance case management repository, ensuring data integrity, reporting accuracy, and effective system utilization.
  • Keep written compliance standards, including policies, procedures, the Code of Conduct, the Compliance Plan, and Annual Report, current, accurate, and aligned with evolving regulatory requirements and program guidance.
  • Own the design, development, and governance of the compliance education program, including new-hire orientation, annual mandatory training modules, and leadership-focused communications, ensuring materials reflect current regulatory requirements, organizational policies, and risk priorities.
  • Ensure compliance with Medicare Advantage First Tier, Downstream, and Related Entity requirements by monitoring delegated entities, facilitating audits, maintaining documentation, and implementing corrective action plans to meet CMS standards.
  • Facilitate 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.
  • Represent the compliance department on organizational councils, committees, and workgroups to integrate compliance considerations into decision-making, policy development, and operational planning.
  • Provide day-to-day oversight and direction to Regional Compliance and Privacy Managers.
  • Partner with clinical, operational, and administrative leaders to promote integrity, regulatory readiness, and continuous improvement.
  • Serve as a trusted advisor to the Chief Compliance and Privacy Officer and committees and councils as needed.

Desired Qualifications

  • CHC, CRMA, CCEP, or equivalent certification.

About the Company

Medical University of South Carolina

Health sciences university in Charleston, SC

Medical University of South Carolina is a public academic health sciences university in Charleston, South Carolina. It offers bachelor's, master's, doctoral, and professional degrees through six colleges in dental medicine, graduate studies, health professions, medicine, nursing, and pharmacy.

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