Healthcare Compliance Director

Job Summary

A company is looking for a Senior Director, Operational Quality & Compliance.

Key Responsibilities:

• Lead enterprise-wide operational quality initiatives and compliance strategies
• Oversee the translation of complex benefit designs into audit-ready configuration specifications
• Drive configuration QA and validation strategies for system migrations and product launches

Qualifications:

• Bachelor's degree or equivalent experience required; advanced degree or relevant certifications preferred
• 10+ years of experience in healthcare operations with expertise in configuration
• Proven success in leading quality, compliance, or system implementation initiatives
• Strong knowledge of CMS and state regulatory frameworks
• Expert-level understanding of healthcare configuration logic and claims adjudication