Director of Compliance, Personal Home Care - REMOTE
The Director of Compliance is responsible for developing, implementing, and overseeing AbriCare's compliance program. This role reports to the Vice President of Clinical Operations and ensures the organization operates in full adherence to federal and state Medicaid regulations, personal care home caregiving and nursing services, and licensure requirements, HIPAA, and applicable private pay standards. The Director of Compliance serves as the organization's subject matter expert on regulatory matters and partners closely with clinical, operations, HR, and billing leadership.
Key Responsibilities
Regulatory & Program Compliance
- Design, implement, and maintain a comprehensive compliance program aligned with OIG guidelines and state Medicaid requirements
- Monitor federal and state regulatory changes (CMS, state Medicaid agencies) and ensure timely policy updates
- Maintain all required licensure, certifications, and provider enrollments (Medicaid, MCO contracts, etc.)
- Serve as the primary point of contact for state surveys, audits, and regulatory inquiries
Billing & Medicaid Integrity
- Oversee Medicaid billing compliance, including EVV (Electronic Visit Verification) adherence
- Partner with billing leadership to ensure claims accuracy, documentation standards, and audit readiness
- Lead internal audits of billing records, service authorizations, and visit documentation
HIPAA & Privacy
- Serve as the organization's HIPAA Privacy Officer (or coordinate with designated officer)
- Maintain and update HIPAA policies, conduct workforce training, and manage breach response protocols
Policies, Training & Culture
- Develop and maintain the compliance policy and procedure library
- Design and deliver compliance training for caregivers, branch staff, and leadership
- Foster a culture of integrity, transparency, and accountability across the organization
Risk Management & Investigations
- Manage the compliance hotline and investigate reported concerns
- Conduct root cause analysis and implement corrective action plans
- Report compliance metrics and risk findings to executive leadership and the Board
Minimum Qualifications
Required:
- Minimum 5 years of experience in a compliance, regulatory, or quality role, minimum 2 years in a supervisory or people management role
- Bachelor's degree required
Preferred:
- Experience in home health or personal care services
- Master's degree in healthcare administration, law, public health, or related field
- CHC (Certified in Healthcare Compliance) certification
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