Director of Compliance Operations & Optimization

Job Description

Job Description

Job Description Summary

Reporting directly to the Chief Compliance and Privacy Officer, this role helps to ensure the organization meets federal, state, accreditation, and other regulatory requirements. The Director serves as a trusted advisor to the Chief Compliance and Privacy Officer and various committees, and councils as needed, while providing day-to-day oversight of and direction to the Regional Compliance and Privacy Managers. The Director partners with leaders across clinical, operational, and administrative areas to promote a culture of integrity, regulatory readiness, and continuous improvement.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC002278 SYS - Compliance Program

Pay Rate Type

Salary

Pay Grade

Health-35

Scheduled Weekly Hours

40

Work Shift

Job Description

The Director

• Ensures communication channels operate effectively to support the timely remediation of compliance concerns raised through internal reports, the hotline, and exit interviews.

• Conducts targeted research across statutes, rules, and guidance documents to develop compliant, evidence‑based advice.

• Monitors, analyzes, and interprets regulatory requirements and industry guidance to assess organizational risk and evaluate the impact on business operations and compliance obligations.

• Directs the Facility Compliance Liaison Program by expanding participation to strengthen local compliance ownership.

• Manages go-live readiness and on-going compliance related to provider-based entities, by identifying areas of vulnerability and collaborating with operational leaders to implement corrective action plans.

• Leads the implementation, administration, and ongoing optimization of the compliance performance management system and enterprise compliance case management repository to include assuring data integrity, reporting accuracy and effective system utilization.

• Ensures written compliance standards — including policies, procedures, the Code of Conduct, the Compliance Plan, and Annual Report — remain current, accurate, and aligned with evolving regulatory requirements and program guidance.

• Owns the design, development, and governance of the compliance education program, including new‑hire orientation, annual mandatory training modules, and leadership‑focused communications, while ensuring such materials reflect current regulatory requirements, organizational policies, and risk priorities.

• Assures compliance with Medicare Advantage First Tier, Downstream, and Related Entity (FDR) requirements by monitoring delegated entities, facilitating audits, maintaining documentation, and implementing corrective action plans to meet CMS standards.

• Facilitates non-billing external audits, investigations, and self‑reporting obligations by coordinating with regulatory agencies, preparing audit materials, overseeing evidence collection, managing cross‑functional responses, and ensuring findings are addressed through corrective action plans.

• Represents the compliance department on various organizational councils, committees, and workgroups to ensure compliance considerations are integrated into decision‑making, policy development, and operational planning.

Additional Job Description

Requirements (Education, Work Experience, Licensure, Registry &/or Certifications):

A bachelor’s degree in a healthcare compliance-related field such as:

legal studies, health information management, nursing, public policy,

risk management, etc. and at least 10 years of relevant experience.

Or a master’s degree in a healthcare compliance-related field such as an:

MBA, MPA, MHA, JD, MSN, MPH, etc. plus 7 years of relevant experience.

Experience and/or ability to interpret and operationalize regulatory requirements related to areas such as:

• Provider-Based Regulations, Stark and Antikickback Statutes, CMS Conditions of Participation, Accreditation Survey Standards, EMTALA Obligations, Conflicts of Interest, Affordable Care Act, Lewis Blackman Act.
• CMS First-Tier Downstream and Related Entity Obligations, 340b Drug Pricing Program Provisions, Cost Reporting Compliance, Durable Medical Equipment Requirements, Research Compliance, Home Infusion Standards.
• Medicare Secondary Payor Requirements, CMS Quality Reporting Programs, Telehealth Regulations, Direct and Indirect Graduate Medical Education (GME) requirements, and Fraud, Waste and Abuse Obligations.

Strong leadership, consultative and analytical skills are required.

Must exhibit exceptional interpersonal and communications skills and be able to work independently with minimal
supervision.

Works well in a fast-paced, growing environment that requires adaptability, collaboration, and proactive problem
solving.

Proficient in modern technology platforms and emerging AI capabilities, with the ability to evaluate, adopt, and apply digital tools to improve efficiency, analytics, and program effectiveness.

CHC, CRMA, CCEP or equivalent preferred.

Physical Requirements

• Ability to perform job functions while standing. (Frequent) 
• Ability to perform job functions while sitting. (Frequent) 
• Ability to perform job functions while walking. (Frequent) 
• Ability to climb stairs. (Infrequent) 
• Ability to work indoors. (Continuous) 
• Ability to work from elevated areas. (Frequent) 
• Ability to work in confined/cramped spaces. (Infrequent) 
• Ability to perform job functions from kneeling positions. (Infrequent) 
• Ability to bend at the waist. (Frequent) 
• Ability to squat and perform job functions. (Infrequent) 
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Frequent) 
• Ability to reach in all directions. (Frequent) 
• Possess good finger dexterity. (Continuous) 
• Ability to fully use both legs. (Continuous) 
• Ability to fully use both hands/arms. (Continuous) 
• Ability to lift and carry 15 lbs. unassisted. (Infrequent) 
• Ability to lift/lower objects 15 lbs. from/to floor from/to 36 inches unassisted. (Infrequent) 
• Ability to lift from 36 inches to overhead 15 lbs. (Infrequent) 
• Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous) 
• Ability to see and recognize objects close at hand or at a distance. (Continuous) 
• Ability to match or discriminate between colors. (Continuous) *(Selected Positions) 
• Ability to determine distance/relationship between objects; depth perception. (Continuous) 
• Ability to maintain hearing acuity, with correction. (Continuous) 
• Ability to perform gross motor functions with frequent fine motor movements. (Continuous) 
• Ability to work in a latex safe environment. (Continuous)
• *Ability to maintain tactile sensory functions. (Frequent) *(Selected Positions)
• *Ability to maintain good olfactory sensory function. (Frequent) *(Selected Positions)

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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