Healthcare Compliance Director

Job Summary

Owning quality assurance and compliance operations across state Medicaid programs and health plans, the fully remote Director of Quality and Compliance will manage standard operating procedures, oversee incident management, lead root cause analyses, and ensure regulatory compliance in a healthcare startup environment.

Key responsibilities

• Own and maintain standard operating procedures (SOPs) and document control, ensuring compliance with regulatory changes
• Manage incidents end to end, including triaging, reporting, and tracking follow-up actions for incidents of abuse, neglect, or exploitation
• Lead root cause analysis and corrective action plans, collaborating with clinical consultants and presenting findings to the Health Equity and Quality Metrics Committee

Required qualifications

• Clinical license (e.g., RN, LCSW, LPC) or a bachelor's degree in a health-related field or business/operations management
• 7+ years of experience in healthcare quality, compliance, risk management, or operations management
• Experience with multistate compliance and regulatory reporting, particularly in Medicaid managed care
• Proven ability to lead incident management and root cause analyses
• Strong writing skills for SOPs, regulatory responses, and committee reports