Chief Compliance Officer

Overview

We are seeking an experienced and strategic Chief Compliance Officer (CCO) to lead our organization is fully compliant and risk management initiatives operationally sound, and proactively protected across all clinical, regulatory, and payer-facing activities.

This role is not revenue-owning, but revenue-protective. The CCO works in close partnership with the CFO, COO, and clinical leadership to ensure that billing, coding, documentation, payer strategy, staff operations, and patient-facing processes are legally compliant, audit-ready, and strategically structured.

This individual serves as the organization’s first line of defense against regulatory risk, payer disputes, documentation failures, and compliance breakdowns, while enabling ethical, defensible, and scalable growth. The ideal candidate will oversee the development, implementation, and enforcement of compliance policies, ensuring adherence to legal standards and internal procedures. This leadership role requires a proactive approach to managing regulatory requirements, fostering a culture of integrity, and supporting business growth through strategic compliance practices.

The CCO will collaborate with senior leadership to align compliance objectives with the organization's overall goals, driving operational excellence and sustainable development.

Medical & Regulatory Compliance Leadership

• Serve as the internal authority on healthcare compliance and regulatory governance
• Ensure compliance with:
• HIPAA / HITECH
• Commercial payer requirements
• State and federal healthcare laws
• Proactively identify compliance risks and implement mitigation strategies before issues arise
• Lead internal compliance audits and prepare the organization for external audits or payer reviews

Medical Operations & Clinical Governance

• Oversee medical operations compliance across all service lines and providers
• Ensure workflows align with:
• Supervision and delegation requirements
• Documentation and medical necessity standards
• Partner with clinical leadership to support compliant rollout of new procedures, services, and modalities
• Establish and maintain clinical SOPs that protect providers and the organization
• Provide governance and oversight of the billing and coding teams
• Ensure accurate and compliant use of:
• CPT, ICD-10, HCPCS codes
• Modifiers and payer-specific rules
• Work with providers to:
• Align templates and notes with payer and regulatory requirements
• Reduce denials and post-payment risk
• Ensure documentation supports medical necessity, prior authorization, and audit defensibility

Payer Governance & Payer-Mix Strategy

• Ensure the organization maintains a buttoned-up, compliant payer strategy
• Oversee governance of:
• Out-of-network billing
• Hybrid and self-pay workflows
• Ensure compliance with:
• Balance billing rules
• Fair Health benchmarking (where applicable)
• Partner with CFO and COO to ensure payer mix decisions are legally sound, defensible, and sustainable

HIPAA, Consents & Patient-Facing Compliance

• Own and maintain all patient-facing compliance documentation, including:
• HIPAA notices and acknowledgments
• Financial responsibility disclosures
• Medicare/Medicaid-required forms
• Ensure forms are:
• Legally compliant
• Operationally integrated into EMR workflows
• Consistently executed and audited
• Lead privacy risk assessments and incident response planning

Staff Compliance, Training & Accountability

• Ensure all staff meet compliance requirements related to:
• Licensing and credentialing
• Scope of practice
• HIPAA and privacy
• Internal policies and SOPs
• Oversee compliance components of:
• Staff onboarding
• Annual training
• Attestations and acknowledgments
• Partner with HR and operations on corrective action, retraining, or remediation when compliance gaps arise
• Handle all contracts coming in adn going out for any vendors, partners, 1099's, leases, etc.

Cross-Functional Leadership & Partnership

• Work collaboratively with:
• COO (operations, workflows, staffing)
• Serve as a strategic advisor on compliance implications for growth, expansion, and new service lines
• Translate complex regulations into clear, practical operational guidance
• Lead efforts in risk assessment, mitigation strategies, and process improvements to enhance…