Director, Compliance

Position Title: Director, Compliance

Reports To: Chief Legal Officer

Division: AA – CORPORATE EH-SS

Department: Legal and Compliance

Classification : Non-exempt

Places of Work: Remote

People Leader: No

About the Organization:

Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.

Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.

In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.

About the Role:

The Director, Compliance will build and oversee the governance and compliance infrastructure that protects the business, enables strategic growth, and ensures regulatory excellence and integrity at every level. This role serves as the operational partner to the General Counsel and covers multiple lines of business and across multiple states, and includes compliance with the rules and regulations of the Centers for Medicare and Medicaid Services, as well as state Medicaid agencies. Responsibilities include, but are not limited to, the development and standardization of policies and procedures for compliance, auditing and monitoring, training and education, compliance investigations, and reporting. This is a builder role for a compliance leader who thrives in a fast-paced, mission-driven environment.

Key Responsibilities:

• Design, implement, and manage an enterprise compliance program that scales with the organization.
• Translate complex federal and state regulatory requirements into clear, actionable policies, procedures, and controls for operational teams.
• Build and maintain a compliance dashboard, risk register, and audit-readiness framework.
• Develop and deliver compliance training programs that build a culture of regulatory accountability.
• Monitor the regulatory landscape and proactively identify emerging compliance risks and obligations.
• Manage compliance hotline process, which includes investigation, follow-up, and corrective action as necessary.
• Lead enterprise risk assessment processes, identifying, prioritizing, and mitigating compliance risks.
• Manage and conduct internal audits to ensure compliance with Stark, Anti-kickback, Conflict of Interest, Fraud, Waste and Abuse, and other relevant laws and regulations.
• Ensure data privacy, data rights, and communications compliance controls are embedded in operational workflows.
  
  

Required Skills & Qualifications:

• Minimum of 10 years experience in healthcare compliance, regulatory matters, and/or legal operations in complex healthcare organizations participating in governmental health care programs including Medicaid and Medicare.
• Strong understanding of Medicare and Medicaid reimbursement, Fraud, Waste and Abuse, HIPAA, Anti-Kickback Statute, data privacy and security laws and regulations.
• Bachelor’s Degree in related field
• Excellent communication skills
• Strong interpersonal and organizational skills to collaborate and influence
• Some travel may be required <10%

Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.