Legal Clinical Quality Compliance Advisor

Role Overview

• Partner with leadership to implement and maintain a healthcare compliance program that promotes a culture of compliance and patient safety
• Oversee ongoing testing and monitoring processes to improve program effectiveness
• Collaborate across departments to route compliance issues appropriately (e.g., clinical complaints, privacy, ethics)
• Participate in prevention, detection, and correction of compliance issues (e.g., chart reviews, clinician interactions, billing audits)
• Review and help develop policies to ensure compliance with federal and state laws
• Identify compliance risks and implement corrective actions
• Provide regular reports to senior management on compliance operations and progress

Requirements

• College degree, healthcare compliance certification, or equivalent experience
• Healthcare provider licensure (RN, NP, RPh, PA) or equivalent clinical/quality experience
• 5+ years in a care delivery setting (in-person or virtual), with knowledge of medical group/specialty practices, urgent care, and employer-site clinics
• Familiarity with billing/coding standards, accreditation, and quality programs preferred
• Basic understanding of payer regulations (Medicare FFS, Medicare Advantage, Medicaid)
• Strong written and verbal communication skills
• Ability to work independently and manage multiple priorities
• Detail-oriented with analytical skills for regulatory/business data
• Self-starter with a growth mindset
• Collaborative and influential team player

Benefits

• medical, vision, dental
• well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays