Director, Compliance Data Insights and Analytics (Remote)

Primary Duties

• Advanced Data Analysis: Perform complex data mining and trend analysis to proactively assess compliance risks and enhance monitoring mechanisms, guiding the organization toward preventive measures.
• Strategic Dashboard Development: Create comprehensive compliance dashboards and automated reporting systems to enhance compliance program maturity and effectiveness, and to provide real-time insights into compliance performance and business insights.
• Predictive Modeling Leadership: Develop and implement predictive models to assess risk and identify strategic areas for compliance intervention, while optimizing resource allocation.
• Technology and System Optimization Leadership: Drive technological initiatives and system optimizations to align compliance operations with cutting-edge data analytics processes; develop automation to identify abnormalities and outliers that may be an indicator of non-compliance
• Cross-Departmental Leadership: Work cross-functionally to support all compliance functions (e.g., investigations, monitoring, risk assessment) to address compliance-related issues and help support the implementation of effective controls; Spearhead collaborative efforts across Product, Tech, BI, and other departments to ensure seamless data integration and process improvement, advocating for technological enhancements and compliance innovations.
• Analytical Strategy and Executive Reporting: Provide executive-level compliance insight based on data analytics to facilitate compliance discussions at the Board of Directors and Compliance Committee level; Develop metrics to measure progress against compliance program maturity model goals; Collaborate with the Compliance leadership to assess current program maturity levels and identify opportunities for enhancement.

Minimum Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• Minimum of 8 years of progressive experience in data analytics with a strong focus on healthcare compliance program management, monitoring, auditing, or a combination of these areas.
• Proficiency in Tableau, SQL, and visualization tools
• Strong knowledge of HIPAA, fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).
• Excellent analytical, problem-solving, and critical thinking skills.
• Exceptional written and verbal communication skills, with the ability to translate complex data findings into clear and actionable guidance.
• Strong interpersonal skills and the ability to collaborate effectively with diverse teams.

Preferred knowledge, skills, and/or abilities

• Understanding of healthcare regulations, including those specific to Accountable Care Organizations (ACOs) and value-based care models (e.g., MSSP, Direct Contracting).
• Compliance certification (e.g., CHC, CCEP).
• Experience with compliance management software or platforms.
• Experience working in a rapidly growing organization or startup environment.
• Familiarity with compliance program maturity models (e.g., OIG Seven Elements, DOJ Guidelines).
• Proficiency in G-Suite or Microsoft Office Suite.

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.