Director of Compliance

Director Of Compliance

The mission of The Los Angeles Cancer Network is to provide unparalleled care to each patient that comes through our doors. We offer individualized treatment using the most recent and relevant proven advances in cancer care, curated with deliberation and compassion. LACN is committed to educating and supporting our patients and their families through every step of the way. We deliver a unique approach for every patient to ensure they receive treatment best suited to their condition, age, and other important factors. We do this by participating in important clinical research, encouraging screenings for early detection, and providing innovative treatment. We are proud to be at the forefront of cancer research through our partnership with OneOncology.

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description

The Director of Compliance is responsible for developing, implementing, and overseeing the organization's Corporate Compliance Program across all physician practice locations. This position ensures compliance with federal, state, and local laws and regulations governing physician practices, specialty oncology services, infusion centers, pharmacy operations, laboratory services, and clinical research (if applicable). The Director serves as a strategic advisor to executive leadership while promoting a culture of ethics, integrity, and regulatory compliance.

Essential Duties and Responsibilities

• Develop, implement, and maintain an effective Corporate Compliance Program.
• Conduct annual enterprise-wide compliance risk assessments.
• Develop annual compliance work plans based on identified risks.
• Present compliance reports to Executive Leadership and the Board or Compliance Committee.
• Maintain the organization's Code of Conduct and compliance policies.

Regulatory Compliance

• Centers for Medicare & Medicaid Services (CMS)
• California Department of Public Health (CDPH)
• California Medical Board requirements
• California Department of Health Care Services (DHCS)
• Office of Inspector General (OIG)
• Department of Justice (DOJ)
• HIPAA Privacy and Security Rules
• OSHA
• California labor regulations affecting healthcare operations
• Federal and California Fraud, Waste, and Abuse laws
• False Claims Act
• Anti-Kickback Statute
• Stark Law
• Medicare and Medi-Cal regulations

Physician Practice Compliance

• Monitor compliance across multiple satellite physician offices.
• Ensure provider credentialing and licensure compliance.
• Oversee medical record documentation compliance.
• Evaluate coding and billing practices.
• Monitor incident-to billing requirements.
• Oversee provider enrollment compliance.
• Coordinate internal compliance audits.

Oncology-Specific Compliance

• Monitor chemotherapy and biologic administration compliance.
• Ensure compliance with infusion center standards.
• Oversee hazardous drug handling standards.
• Monitor oral oncology dispensing compliance (if applicable).
• Ensure compliance with prior authorization requirements.
• Support oncology quality initiatives.
• Assist with accreditation readiness (e.g., oncology-specific accreditation programs).

Privacy and HIPAA

• Serve as Privacy Officer or collaborate closely with the Privacy Officer.
• Investigate privacy incidents and breaches.
• Oversee HIPAA training.
• Conduct HIPAA risk assessments.
• Ensure Business Associate Agreements are maintained.

Auditing and Monitoring

• Develop and oversee audits including:
• Medical record documentation
• Evaluation & Management coding
• Chemotherapy administration documentation
• Infusion billing
• Modifier usage
• Incident-to billing
• Medical necessity
• Clinical documentation integrity
• Provider documentation
• Laboratory compliance
• Pharmacy compliance

Investigations

• Investigate compliance concerns.
• Manage anonymous reporting hotline.
• Conduct internal investigations.
• Recommend corrective actions.
• Monitor corrective action plans.

Education and Training

• Develop annual compliance education for:
• Physicians
• Advanced Practice Providers
• Nurses
• Medical Assistants
• Clinical Research staff
• Revenue Cycle
• Front Office staff
• Leadership

Policies and Procedures

• Develop and revise compliance-related policies.
• Ensure policies remain current with changing regulations.
• Standardize compliance practices across all satellite offices.

Risk Management

• Perform compliance risk assessments.
• Identify emerging regulatory risks.
• Develop mitigation strategies.
• Monitor corrective actions.

Accreditation and Regulatory Surveys

• Coordinate readiness for organizations such as:
• Accreditation surveys
• State inspections
• CMS audits
• OIG audits
• Commercial payer audits

Revenue Cycle Compliance

• Collaborate with Revenue Cycle to monitor:
• Coding accuracy
• Charge capture
• Billing compliance
• Refunds and overpayments
• Credit balance management
• Denials related to compliance

Clinical Research Compliance

• Ensure compliance with research regulations.
• Monitor informed consent requirements.
• Coordinate with Institutional Review Boards (IRBs).
• Support Good Clinical Practice (GCP) standards.

Pharmacy Compliance

• Monitor specialty pharmacy regulations.
• Ensure compliance with drug storage requirements.
• Oversee controlled substance policies.
• Monitor drug diversion prevention.

Qualifications

Education

• Bachelor's degree required.
• Master's degree in Healthcare Administration, Business Administration, Public Health, Nursing, Law, or related field preferred.

Experience

• 810 years of progressive healthcare compliance experience.
• At least 5 years in physician practice compliance.
• Multi-site healthcare organization experience required.
• Oncology experience strongly preferred.
• Experience with Medicare and Medi-Cal regulations.
• Experience managing compliance investigations and audits.

Preferred Certifications

• Certified in Healthcare Compliance (CHC)
• Certified in Healthcare Privacy Compliance (CHPC)
• Certified Professional Coder (CPC) (preferred)
• Registered Health Information Administrator (RHIA) (preferred)

Knowledge and Skills

• Extensive knowledge of physician practice regulations.
• Oncology regulatory expertise.
• Medicare and Medi-Cal billing compliance.
• HIPAA Privacy and Security.