Job Closed
This listing is no longer active.
RCM Compliance Program Director
Location
Florida
Posted
108 days ago
Salary
0
Seniority
Lead
Job Description
RCM Compliance Program Director
ModMed
• Own and operate the BOOST RCM Compliance Program, ensuring it is fully documented, auditable, and scalable. • Establish and maintain compliance controls, monitoring activities, and escalation protocols across RCM workflows. • Ensure audit readiness by partnering closely with internal audit to support reviews, testing, and remediation activities. • Continuously assess the RCM regulatory landscape (e.g., coding, billing, reimbursement, payer requirements, federal and state regulations) to identify compliance risks. • Define the organization’s risk tolerance in partnership with executive leadership across RCM, Compliance and Legal. • Translate regulatory requirements into a clear compliance framework, including: What the organization will monitor and scan for; How violations or risks are identified; Defined “then what” response guidelines, remediation steps, and corrective action plans. • Partner closely with Legal, Compliance, RCM Operations, Product, and Customer Success to ensure alignment on compliance expectations and execution. • Provide subject-matter expertise to support legal interpretation, policy development, and customer-facing compliance discussions. • Act as a trusted advisor to senior leadership on compliance risks, tradeoffs, and mitigation strategies. • Execute the compliance program end-to-end, including monitoring, reporting, issue resolution, and documentation. • Enhance and evolve the program as the business, regulatory environment, and customer needs change. • Develop metrics and reporting to track compliance trends, risk areas, and program effectiveness. • Serve as a compliance subject-matter expert in customer conversations, audits, or regulatory inquiries as needed.
Job Requirements
- Bachelor’s degree; Masters degree strongly preferred
- 10+ years of experience in Revenue Cycle Management, healthcare compliance, coding, billing, or reimbursement-related roles.
- Deep understanding of the RCM regulatory environment, including coding, billing, payer rules, and compliance risk management.
- Proven experience designing, implementing, and executing compliance programs in a healthcare or healthcare technology environment.
- Strong ability to translate complex regulatory requirements into practical, executable business guidelines.
- Executive-level communication skills with the ability to engage confidently with senior leaders, Legal partners, auditors, and customers.
- Experience supporting or partnering with audit functions.
- Background in healthcare SaaS, RCM services, or scaled healthcare operations.
- Prior experience in a director-level individual contributor or enterprise compliance leadership role.
Benefits
- Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
- 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
- Generous Paid Time Off and Paid Parental Leave programs
- Company paid Life and Disability benefits
- Flexible Spending Account, and Employee Assistance Programs
- Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
- Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
- Global presence and in-person collaboration opportunities; dog-friendly HQ (US)
- Hybrid office-based roles and remote availability for some roles
- Weekly catered breakfast and lunch
- Treadmill workstations, Zen, and wellness rooms within our BRIC headquarters
Related Guides
Related Categories
Related Job Pages
More Program Manager Jobs
• Plan, organize, and manage multiple research projects from inception to completion, ensuring they meet timelines and quality standards. • Coordinate cross-functional teams, including genomic researchers, data scientists, bioinformaticians, genetic counselors and medical geneticists, fostering effective collaboration and communication. • Maintain budgets for research programs, including financial planning, tracking, and reporting. • Identify potential risks for genomic research projects and develop mitigation strategies to ensure successful outcomes. • Ensure all research activities comply with LDT and FDA regulatory requirements, ethical standards, and organizational policies in collaboration with quality department. • Maintain effective communication with stakeholders, including senior leadership, product owners, software developers and lab directors, providing regular updates and reports. • Monitor project progress and performance, using metrics and data to evaluate success and identify areas for improvement. • Ensure thorough documentation of research processes, SOPs, findings, and outcomes, maintaining accurate and comprehensive records. • Using your expertise in genetics and program management, drive innovation in diagnostic testing, analysis and interpretation through genomic research projects and transfer into the commercial laboratory. • Contribute to data analytics, genetic interpretation and/or the evaluation of software tools for clinical genomic analysis and research, approximately 20% time.
Vice President, Strategic Implementation – Program Operations
Lehigh Valley Health NetworkLife is full of partners. Your health deserves one, too.
• Deploys and directs a team of professionals to support the enterprise in achieving its goals through the implementation of key initiatives and strategic projects. • Provides direct coaching and feedback to less experienced team members. • Designs, implements, and upholds the standards and processes for the Strategic implementation partners program (leveraging technology and program templates) in support of the implementation of the key enterprise and strategic initiatives. • Continually seek for opportunities to improve the customer experience and enhance the effectiveness and efficiencies of the program. • Collaborate with other stakeholders to align on the enterprise approach with leveraging tools to drive the implementation, management, and reporting of strategic initiatives. • Builds and develops relationships both internal to the enterprise as well as a professional network including any external consultants/vendors and membership in relevant professional organizations. • Build and lead high-performing cross-functional teams to execute transformation initiatives effectively.
Program Manager – Partnerships
Vatica HealthThe next generation of risk adjustment and quality of care
The Program Manager, Partnerships is responsible for the day-to-day execution, coordination, and delivery of IHA Performance Measurement Programs supported by Cozeva. This role partners closely with the Director of Partnerships, IHA to operationalize program strategy and ensure accurate, timely, and compliant delivery across CalPERS, CAPCI, and AMP/Atlas. • Manage day-to-day execution of assigned IHA programs, ensuring milestones, deliverables, and timelines are met. • Track program requirements, data submission schedules, testing cycles, and reporting deadlines. • Maintain detailed program plans, risk logs, issue tracking, and resolution workflows. • Translate documented program requirements into actionable tasks for data, product, and engineering teams. • Coordinate development, validation, and release activities tied to program needs. • Monitor data ingestion, analytics outputs, and reporting accuracy; flag issues and drive resolution. • Partner with Customer Success and Implementation teams to support onboarding, training, and ongoing operational needs for participating health plans. • Ensure health plans receive clear documentation, timelines, and support pathways for program participation. • Track data submission compliance and support issue resolution in collaboration with internal teams. • Serve as a key operational point of contact for IHA program teams and internal stakeholders. • Prepare and distribute program communications, status updates, and meeting materials. • Maintain program dashboards and tracking tools to ensure visibility into status, risks, and dependencies. • Escalate issues, risks, and decision points to the Director of Partnerships, IHA with clear context and recommendations. • Support continuous improvement by documenting lessons learned and operational enhancements.
Senior Program Manager, Partnerships
Vatica HealthThe next generation of risk adjustment and quality of care
The Senior Program Manager, Partnerships is responsible for the day-to-day execution, coordination, and delivery of IHA Performance Measurement Programs supported by Cozeva. This role partners closely with the Director of Partnerships, IHA to operationalize program strategy and ensure accurate, timely, and compliant delivery across CalPERS, CAPCI, and AMP/Atlas. This role is highly execution-focused and requires strong program management discipline, technical fluency, and stakeholder coordination skills to manage dependencies across IHA, participating health plans, and internal Cozeva teams. Responsibilities: Program Execution & Delivery - Manage day-to-day execution of assigned IHA programs, ensuring milestones, deliverables, and timelines are met. - Track program requirements, data submission schedules, testing cycles, and reporting deadlines. - Maintain detailed program plans, risk logs, issue tracking, and resolution workflows. Technical & Operational Coordination - Translate documented program requirements into actionable tasks for data, product, and engineering teams. - Coordinate development, validation, and release activities tied to program needs. - Monitor data ingestion, analytics outputs, and reporting accuracy; flag issues and drive resolution. Health Plan Implementation Support - Partner with Customer Success and Implementation teams to support onboarding, training, and ongoing operational needs for participating health plans. - Ensure health plans receive clear documentation, timelines, and support pathways for program participation. - Track data submission compliance and support issue resolution in collaboration with internal teams. Stakeholder Communication & Coordination - Serve as a key operational point of contact for IHA program teams and internal stakeholders. - Prepare and distribute program communications, status updates, and meeting materials. - Support governance forums, working groups, and operational check-ins. ** Reporting & Program Transparency - Maintain program dashboards and tracking tools to ensure visibility into status, risks, and dependencies. - Escalate issues, risks, and decision points to the Director of Partnerships, IHA with clear context and recommendations. - Support continuous improvement by documenting lessons learned and operational enhancements.



