Director of Compliance

Director Of ComplianceThe 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 DescriptionThe 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 ResponsibilitiesDevelop, 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 ComplianceCenters for Medicare & Medicaid Services (CMS)California Department of Public Health (CDPH)California Medical Board requirementsCalifornia Department of Health Care Services (DHCS)Office of Inspector General (OIG)Department of Justice (DOJ)HIPAA Privacy and Security RulesOSHACalifornia labor regulations affecting healthcare operationsFederal and California Fraud, Waste, and Abuse lawsFalse Claims ActAnti-Kickback StatuteStark LawMedicare and Medi-Cal regulationsPhysician Practice ComplianceMonitor 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 ComplianceMonitor 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 HIPAAServe 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 MonitoringDevelop and oversee audits including:Medical record documentationEvaluation & Management codingChemotherapy administration documentationInfusion billingModifier usageIncident-to billingMedical necessityClinical documentation integrityProvider documentationLaboratory compliancePharmacy complianceInvestigationsInvestigate compliance concerns.Manage anonymous reporting hotline.Conduct internal investigations.Recommend corrective actions.Monitor corrective action plans.Education and TrainingDevelop annual compliance education for:PhysiciansAdvanced Practice ProvidersNursesMedical AssistantsClinical Research staffRevenue CycleFront Office staffLeadershipPolicies and ProceduresDevelop and revise compliance-related policies.Ensure policies remain current with changing regulations.Standardize compliance practices across all satellite offices.Risk ManagementPerform compliance risk assessments.Identify emerging regulatory risks.Develop mitigation strategies.Monitor corrective actions.Accreditation and Regulatory SurveysCoordinate readiness for organizations such as:Accreditation surveysState inspectionsCMS auditsOIG auditsCommercial payer auditsRevenue Cycle ComplianceCollaborate with Revenue Cycle to monitor:Coding accuracyCharge captureBilling complianceRefunds and overpaymentsCredit balance managementDenials related to complianceClinical Research ComplianceEnsure compliance with research regulations.Monitor informed consent requirements.Coordinate with Institutional Review Boards (IRBs).Support Good Clinical Practice (GCP) standards.Pharmacy ComplianceMonitor specialty pharmacy regulations.Ensure compliance with drug storage requirements.Oversee controlled substance policies.Monitor drug diversion prevention.QualificationsEducationBachelor's degree required.Master's degree in Healthcare Administration, Business Administration, Public Health, Nursing, Law, or related field preferred.Experience8–10 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 CertificationsCertified in Healthcare Compliance (CHC)Certified in Healthcare Privacy Compliance (CHPC)Certified Professional Coder (CPC) (preferred)Registered Health Information Administrator (RHIA) (preferred)Knowledge and SkillsExtensive knowledge of physician practice regulations.Oncology regulatory expertise.Medicare and Medi-Cal billing compliance.HIPAA Privacy and Security.