Director of Regulatory Compliance

• Pay or shift range: $150,000 USD to $160,000 USD The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.

Humboldt Park Healthis a safety-net hospital located in the Humboldt Park neighborhood of Chicago. We are dedicated to delivering high-quality, affordable, and compassionate healthcare services to the communities we serve.

As a primary community healthcare provider, Humboldt Park Health focuses on treating and curing disease while promoting wellness through health education, prevention, and early intervention. Our 200-bed hospital provides inpatient acute care, emergency services, diagnostic services, and primary care. We also support the community through a full-service professional building, neighborhood clinics, and two mobile health units.

We are currently seeking a Full-Time
Director of Regulatory Compliance
to join our team!

Position Summary:

The Director of Regulatory Compliance is responsible for developing, implementing, and sustaining a comprehensive regulatory compliance and continuous survey readiness program across Humboldt Park Health. Reporting directly to the Vice President of Quality & Risk Management, this leader serves as the hospital's operational authority for regulatory compliance and accreditation readiness.

The Director ensures the organization maintains continuous compliance with all applicable federal, state, and accreditation standards, including but not limited to The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), Illinois Department of Public Health (IDPH), Occupational Safety and Health Administration (OSHA), Centers for Disease Control and Prevention (CDC), and other applicable regulatory agencies.

This position partners with executive leadership, physicians, nursing leadership, department directors, and frontline staff to foster a culture where survey readiness is integrated into daily operations rather than viewed as a periodic event. The Director is expected to be a highly visible leader who spends the majority of time in clinical and operational areas validating compliance, coaching leaders, conducting tracers, identifying risks, and ensuring regulatory excellence throughout the organization.

Essential Duties and Responsibilities:

Regulatory Compliance Leadership

• Lead the hospital's continuous regulatory compliance and survey readiness program.
• Develop strategic plans to ensure ongoing compliance with all applicable regulatory and accreditation standards.
• Serve as a subject matter expert regarding regulatory requirements.
• Interpret new and revised standards and translate them into operational expectations.
• Collaborate with executive leadership to establish regulatory priorities.
• Monitor organizational compliance through proactive rounding, audits, and performance indicators.
• Identify regulatory risks before they become survey findings.
• Maintain readiness for unannounced surveys at all times.
• Direct all organizational efforts related to continuous readiness for:
  The Joint Commission, CMS Conditions of Participation, Illinois Department of Public Health, OSHA, CDC guidance, Emergency Preparedness regulations, CMS Quality Programs, and other applicable accrediting or regulatory agencies.
• Responsibilities include coordinating organizational survey readiness activities, leading interdisciplinary readiness committees, maintaining survey documentation, validating corrective actions, conducting readiness rounds, preparing leadership for survey interviews, and ensuring departments maintain evidence of compliance.
• Organizational Tracer Program Develop and oversee a comprehensive tracer program…