Description

We are seeking an experienced, high-caliber Healthcare Compliance professional to support the development, structuring, and ongoing enhancement of comprehensive healthcare compliance and ethics programs for primarily skilled nursing facilities as well as assisted living facilities, hospices, hospitals, and other healthcare providers across the entire United States.

Because we operate nationwide, this role requires a professional with a command of federal healthcare frameworks as well as the agility to research, track, and operationalize state-specific administrative codes, Medicaid rules, and Department of Health survey standards across various state jurisdictions. The individual will conduct regulatory research, draft practical facility-level policies and operational tools, build staff training modules, and help maintain effective, operationalized compliance and ethics programs.

Key Responsibilities:

Nationwide Regulatory Research and Analysis: Conduct in-depth research and comparative analysis of federal regulations and varying state-level healthcare laws, licensing standards, Medicaid program rules, and state survey inspection protocols across all 50 states.
Compliance and Ethics Program Structuring: Design, refine, and support end-to-end healthcare compliance and ethics programs aligned with HHS-OIG General Compliance Program Guidance and long-term care industry benchmarks.
Policy and Procedure Drafting: Draft, review, and standardize tailored, facility-ready compliance policies and procedures.
Tool and Form Development: Build practical operational tools, auditing and monitoring templates, annual risk assessment matrices, compliance committee dashboards, and investigation intake forms.
Training Module Creation: Develop engaging, practical compliance training modules, slide presentations, facilitator guides, and knowledge-check quizzes covering different compliance program issues.
Regulatory Alignment: Ensure all deliverables meet CMS Long-Term Care Requirements of Participation (42 CFR Part 483), CMS State Operations Manual Appendix PP standards (F-Tags), Section 1557 civil rights mandates, and applicable state administrative codes.
FWA and Statutory Oversight: Analyze and incorporate requirements stemming from federal and state fraud, waste, and abuse frameworks, including the federal False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, and diverse state-level False Claims and Medicaid fraud statutes.
Required Qualifications

Background: Minimum of 5+ years of dedicated regulatory compliance, legal, or oversight experience in skilled nursing facilities, post-acute care, or other healthcare provider.
Multi-State / Nationwide Familiarity: Demonstrated capability to navigate and research multi-jurisdictional state regulatory environments, state Medicaid compliance mandates, and individual state Department of Health survey procedures.
Comprehensive Compliance Program Experience: Hands-on experience developing, auditing, or operationalizing full-scope healthcare compliance and ethics programs reflecting HHS-OIG guidance and the Federal Sentencing Guidelines.
Instructional and Policy Drafting Skills: Proven track record of drafting clear, operationally viable compliance policies, audit tools, and adult-learning training modules.
Autonomy: Ability to independently manage projects from multi-jurisdictional research through final deliverable creation within agreed timelines.
Subject Matter Mastery in FWA: Advanced working knowledge of federal and state fraud, waste, and abuse laws and their practical application to long-term care billing, admissions, vendor arrangements, and physician relationships.
Healthcare Regulatory Breadth: Solid grounding in relevant federal healthcare regulations, including HIPAA/HITECH, Section 1557 of the ACA, and Medicare/Medicaid conditions of participation.

Preferred Qualifications:

• Professional Certification: Certified in Healthcare Compliance, Certified Compliance and Ethics Professional, or Certified in Healthcare Research Compliance through CCB/HCCA.
• Education / Credentials: Juris Doctor, Master of Health Administration, Master of Laws in Health Law, or relevant clinical-compliance credentials (e.g., RN with legal/compliance experience).
• Experience creating multi-state policy crosswalks and training modules.

How to Apply

Please submit:

• Your resume / CV highlighting your healthcare compliance background and long-term care experience across single- or multi-state operations.
• Your standard per diem hourly rate or project rate structure.

Email Resume to : fmuller@compliancecgllc.com