RCM Compliance Program Director

Role Overview

• Own and operate the BOOST RCM Compliance Program, ensuring it is fully documented, auditable, and scalable.
• Establish and maintain compliance controls, monitoring activities, and escalation protocols across RCM workflows.
• Ensure audit readiness by partnering closely with internal audit to support reviews, testing, and remediation activities.
• Continuously assess the RCM regulatory landscape (e.g., coding, billing, reimbursement, payer requirements, federal and state regulations) to identify compliance risks.
• Define the organization’s risk tolerance in partnership with executive leadership across RCM, Compliance and Legal.
• Translate regulatory requirements into a clear compliance framework, including: What the organization will monitor and scan for; How violations or risks are identified; Defined “then what” response guidelines, remediation steps, and corrective action plans.
• Partner closely with Legal, Compliance, RCM Operations, Product, and Customer Success to ensure alignment on compliance expectations and execution.
• Provide subject-matter expertise to support legal interpretation, policy development, and customer-facing compliance discussions.
• Act as a trusted advisor to senior leadership on compliance risks, tradeoffs, and mitigation strategies.
• Execute the compliance program end-to-end, including monitoring, reporting, issue resolution, and documentation.
• Enhance and evolve the program as the business, regulatory environment, and customer needs change.
• Develop metrics and reporting to track compliance trends, risk areas, and program effectiveness.
• Serve as a compliance subject-matter expert in customer conversations, audits, or regulatory inquiries as needed.

Requirements

• Bachelor’s degree; Masters degree strongly preferred
• 10+ years of experience in Revenue Cycle Management, healthcare compliance, coding, billing, or reimbursement-related roles.
• Deep understanding of the RCM regulatory environment, including coding, billing, payer rules, and compliance risk management.
• Proven experience designing, implementing, and executing compliance programs in a healthcare or healthcare technology environment.
• Strong ability to translate complex regulatory requirements into practical, executable business guidelines.
• Executive-level communication skills with the ability to engage confidently with senior leaders, Legal partners, auditors, and customers.
• Experience supporting or partnering with audit functions.
• Background in healthcare SaaS, RCM services, or scaled healthcare operations.
• Prior experience in a director-level individual contributor or enterprise compliance leadership role.

Benefits

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits
• Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US)
• Hybrid office-based roles and remote availability for some roles
• Weekly catered breakfast and lunch
• Treadmill workstations, Zen, and wellness rooms within our BRIC headquarters