Job Description

Job Details: Level: Senior,

Job Location: MSO Corporate 1000 - Stamford, CT 06905,

Position Type: Full Time, Education Level: Bachelors,

Salary Range: $200,500.00 - $300,800.00 Salary,

Travel Percentage: Some travel between company locations,

Job Shift: Day,

Job Category: Health Care, What you’ll do:

The Vice President, Compliance is the senior executive responsible for the independent leadership, administration, and continuous improvement of the Spire Orthopedic Partners enterprise Compliance and Privacy Program. Supporting a multi-state, multi-practice healthcare Management Services Organization, outpatient orthopedic specialty practices, ancillary services, and Ambulatory Surgery Centers, this leader establishes a risk-based framework to prevent, detect, investigate, and remediate conduct inconsistent with law, regulation, contractual requirements, organizational policy, or ethical standards. The Vice President reports directly to the Chief Executive Officer and has direct, unrestricted access to the appropriate governing body or committee for significant compliance matters. The role partners closely with clinical, operational, revenue cycle, finance, legal, human resources, information technology, security, and physician leadership while maintaining the authority, visibility, resources, and independence required for an effective compliance function.

Responsibilities/Duties

• Set the enterprise compliance and privacy strategy and lead the design, implementation, evaluation, and continuous improvement of the Compliance Program across all Spire Orthopedic Partners entities, supported practices, ancillary services, and Ambulatory Surgery Centers.
• Serve as a strategic and independent advisor to the Chief Executive Officer, Executive Leadership Team, physician leaders, and the appropriate governing body or committee; report regularly on priority risks, investigations, audit results, corrective actions, emerging requirements, and overall program effectiveness.
• Chair or lead the enterprise compliance committee and establish clear accountability, escalation, documentation, and decision-making processes across operating entities, markets, practices, and facilities.
• Lead the enterprise compliance risk assessment and annual work-planning process, maintaining a prioritized risk register and mitigation plans for regulatory, billing, coding, reimbursement, privacy, security, operational, financial, and business-conduct risks.
• Oversee risk-based monitoring, auditing, data analysis, and control testing involving medical necessity, documentation, coding, charge capture, claims, denials, refunds, physician compensation and referral arrangements, conflicts of interest, exclusion screening, credentialing, licensure, and other identified risk areas.
• Provide compliance guidance for the MSO model and management services arrangements, supporting appropriate separation of administrative and clinical decision-making and consistent implementation of controls across affiliated professional entities.
• Direct the privacy program, including HIPAA and applicable state privacy requirements, privacy and security risk assessments, business associate oversight, incident and breach response, patient notification, mitigation, and coordination with Information Technology and Information Security.
• Maintain confidential reporting channels and lead the intake, triage, investigation, escalation, documentation, and resolution of reported or suspected compliance, privacy, fraud, waste, abuse, or ethical concerns; promote good-faith reporting and enforce non-retaliation protections.
• Ensure substantiated matters receive timely root-cause analysis, corrective and preventive action, disciplinary coordination when appropriate, repayment or disclosure assessment, sustainability monitoring, and documented closure.
• Develop, approve, and maintain the Code of Conduct and enterprise compliance and privacy policies, standards, procedures, and controls, with effective governance, version control, communication, and jurisdiction-specific implementation.
• Oversee role-based education for governing bodies, executives, clinicians, leaders, employees, and contractors, including onboarding and annual training; measure completion, comprehension, and program impact.
• Establish third-party compliance oversight, including risk-based due diligence, exclusion and sanction screening, business associate requirements, contractual compliance obligations, monitoring, and escalation for vendors and other business partners.
• Partner with internal General Counsel and other subject matter experts on regulatory interpretation, significant investigations, government disclosures, contracting, and remediation while preserving the independence of the compliance function.
• Serve as the primary compliance liaison to federal and state regulators, accreditation organizations, payors, and other external stakeholders; oversee responses to inquiries, audits, surveys, investigations, and site visits.
• Monitor laws, regulations, enforcement priorities, payor requirements, and industry standards affecting orthopedic practices, surgical facilities, and MSO operations, and translate changes into practical controls, policies, training, and operational guidance.
• Develop dashboards and key compliance indicators covering risks, hotline activity, investigations, audit findings, training, exclusions, corrective actions, and recurring trends; use results to demonstrate effectiveness and drive continuous improvement.

Qualifications: Who you are:

Qualifications

• Education: Bachelor’s degree in healthcare administration, business, law, finance, nursing, health information management, public health, or a related field required; JD, MHA, MPH, MBA, or other relevant advanced degree strongly preferred.
• Experience: At least 10 years of progressively responsible healthcare compliance, privacy, regulatory, legal, audit, or related experience, including substantial leadership responsibility in a complex, multi-site organization.
• Demonstrated success leading and evaluating an enterprise compliance and privacy program with direct interaction with a CEO, executive leadership, physician leaders, and governing bodies.
• Experience with physician enterprises, outpatient specialty care, revenue cycle operations, ancillary services, Ambulatory Surgery Centers, multi-state operations, and growth through acquisitions or affiliations strongly preferred.
• Deep knowledge of healthcare fraud and abuse, including the False Claims Act, Anti-Kickback Statute, Stark Law, billing and coding requirements, overpayment obligations, HIPAA/HITECH, exclusion requirements, and applicable federal and state privacy and regulatory frameworks.
• Working knowledge of ASC regulatory and accreditation expectations, survey readiness, corrective-action management, and the compliance implications of clinical quality and patient-safety requirements preferred.
• Healthcare compliance certification, such as CHC, CHPC, or CHC-F, strongly preferred; ability to obtain an appropriate certification within an established timeframe may be considered.
• Proven ability to exercise independence, discretion, sound judgment, and executive presence while constructively challenging decisions and influencing leaders across decentralized operations.
• Demonstrated capability in enterprise risk assessment, investigations, auditing and monitoring, data analytics, policy governance, training, third-party oversight, and corrective-action validation.
• Exceptional analytical, problem-solving, and decision-making skills, with the ability to translate complex regulatory requirements into practical, scalable business guidance.
• Excellent written, verbal, and presentation skills, including the ability to communicate sensitive matters clearly to governing bodies, executives, clinicians, employees, regulators, and external partners.
• High integrity and strong relationship-building skills, with a demonstrated commitment to confidentiality, accountability, non-retaliation, and an ethical speak-up culture.
• Strong organizational, change-management, and team-development capabilities in a fast-paced, growth-oriented environment; ability to travel to supported practices and facilities as needed.
• Proficiency with Microsoft Office and compliance case-management, auditing, reporting, visualization, and data-analysis tools.

What we offer

• Excellent growth and advancement opportunities
• Dynamic environment
• Access to a diverse network of practitioners
• Broad infrastructure of tools and programs to enhance the employee experience
• Competitive Compensation
• Generous PTO
• Benefits package: health, dental, vision, 401(k), etc.

We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).