Director, Compliance

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.The Opportunity:By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare.Provide Compliance Program leadership for assigned service lines and/or locations, with primary accountability for the oversight of Compliance investigations — ensuring that reported concerns and suspected violations of the Compliance Program are evaluated, investigated, and resolved. This role also serves as a Compliance Liaison to assigned Ensemble clients and/or service lines in accordance with the Compliance Liaison SOP.II. Job CompetenciesCompetency DescriptionLeadership DecisionMaking Makes day-to-day leadership decisions by securing and comparing information from multiple sources to identify issues; commits to an action after weighing alternative solutions against important criteria; effectively communicates decisions to the appropriate people and teams and holds them accountable. Drives results.Delegation Successfully shares authority and responsibilities with others to move decision making and accountability downward through the organization while accomplishing strategic priorities; maintains personal ownership of outcomes without excessive involvement.Leading Teams Inspires and sustains team unity and engagement by developing, motivating, and guiding the team to achieve results together through productive relationships and work.ExecutiveCommunication Clearly and succinctly conveys information and ideas; communicates in a focused and compelling way that captures and holds others’ attention (appropriate, impactful, and clear).Program/ProjectManagement Demonstrates high accountability and responsibility for projects and programs from inception through completion/implementation; manages budget and resource planning and awareness to ensure maximized output, reduced waste, and exceptional results.III. Essential Job FunctionsEnsemble Difference PrinciplesCustomer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.Compliance Investigations OversightLeads Investigations team and personally manages investigations including the following:Evaluate and manage compliance concerns and reports of suspected misconduct and perform and oversee investigations to ensure that all suspected violations of the Compliance Program are fully investigated and resolved.Oversee the intake, triage, prioritization, and assignment of reported compliance matters, ensuring timely and consistent handling in accordance with Compliance Program requirements.Coordinate the implementation of corrective action plans, monitoring progress and completion, and escalating as required — including overseeing complex overpayment/refund activities, claim correction efforts, and the resolution of systemic issues.Develop and perform training associated with investigations, government and payer coding audits, and settlements.Take, research as needed, and respond to day-to-day compliance questions, including providing effective guidance related to Compliance Program requirements and regulatory risk mitigation.Maintain awareness of fraud, waste, and abuse laws and regulations and current industry changes that may impact healthcare revenue cycle services domestically and internationally through personal initiative, continuing education, and peer-to-peer networking.Prepare and provide reports of investigation activities, findings, and outcomes as requested by Compliance Leadership.Compliance Liaison Responsibilities In accordance with the Compliance Liaison SOP, this role also serves as a Compliance Liaison to assigned Ensemble clients and/or service lines:Serve as the Compliance Liaison to assigned Ensemble clients and/or service lines, as assigned by leadership.Act as the primary compliance point of contact for assigned clients and/or service lines, building trusted relationships with client compliance officers and operational leaders.Facilitate timely, two-way communication of compliance matters, regulatory updates, and Compliance Program expectations between Ensemble Compliance and assigned clients and/or service lines.Attend and support recurring client and service line compliance meetings and align compliance activity with client-specific policies and requirements.Identify, triage, and escalate compliance concerns arising within assigned clients and/or service lines, and support resolution and follow-up.Support client-facing audit, monitoring, and reporting activities, and coordinate distribution of compliance communications (e.g., the monthly Regulatory Compliance Digest) to assigned stakeholders.Maintain documentation of liaison activity in accordance with the Compliance Liaison SOP.Join an award-winning companyFive-time winner of “Best in KLAS” 2020-2022, 2024-2025Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-202422 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023Energage Top Workplaces USA 2022-2024Fortune Media Best Workplaces in Healthcare 2024Monster Top Workplace for Remote Work 2024Great Place to Work certified 2023-2024InnovationWork-Life FlexibilityLeadershipPurpose + ValuesBottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact View email address on click.appcast.io posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.Employment Disclaimers – Ensemble #J-18808-Ljbffr