Title: Associate Director, Provider Compliance Location: Wake County United States Ful time Hybrid The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence. Description of Work The NC Medicaid Office of Compliance and Program Integrity (OCPI) monitors the Medicaid community (beneficiaries, providers, vendors and internal staff) for compliance with state and federal regulations and potential fraud, abuse and neglect. OCPI verifies dollars are paid appropriately for covered services by using claim reviews and investigations, implementing recoveries, pursuing recoupments and aggressively identifying other opportunities for cost avoidance. The Associate Director, Provider Compliance is a senior management position responsible for assisting the Deputy Director/Chief Compliance Officer in key activities of DHB's Office of Compliance and Program Integrity unit. This position will be responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State's contracted health plans while developing and implementing procedures for conducting provider audits and investigations in accordance with all federal and state rules and regulations to reduce provider fraud, waste and abuse. This position will ensure NC Medicaid managed care organizations have and follow sound principles and practices for conducting provider audits, investigations and monitoring. This role will work in partnership with DHB Provider Operations and DHB Clinical Policy to facilitate the adequate implementation of provider policies and practices which lead to compliance with Centers for Medicare & Medicaid Services (CMS) rules and guidelines and North Carolina legislative requirements for Medicaid providers. Job Specific Responsibilities: - Lead the development, maintenance and execution of documented policies and procedures for the establishment of OCPI's provider audits and investigations protocol to prevent illegal, unethical, or improper payment of Medicaid dollars. - Lead the development, maintenance and execution of documented policies and procedures for NC Medicaid's approach to effective oversight and monitoring of the State's contracted Managed Care Plans' Special Investigations Units. - Oversee the scope of work development and execution of vendors conducting provider audits and investigations under OCPI responsibility and liaise with other business unit leaders for joint provider audit and investigations efforts. - Enforce provider policies and procedures to include the use of standardized investigations and corrective actions to address identified and reported violations. - Ensure that the processes and procedures are aligned with authorized enforcement authorities. - Develop and perform and/or authorize periodic provider audit initiatives to ensure that compliance with clinical and payment policies is being achieved and that the compliance program is relevant and up to date with the needs and requirements of DHB and CMS. - Successfully liaise and collaborate with OCPI Compliance Analytics, Medicaid Investigations Division (MID), legal counsel (e.g., DHB Attorney, etc.) and others as necessary for expert consultation, clarification and/or approval of provider compliance-based initiatives and interests, to include escalation of high-priority concerns or violations and prosecutions. - Measure and report on operational performance and lead the development of plans to improve relevant key performance indicators within the Provider Compliance unit. - Engage in personnel administration to include but not limited to recruiting, selecting, and managing employees; delegating to staff members; encouraging and fostering professional development; establishing effective professional goals and work plan objectives. Knowledge Skills and Abilities/Management Preferences Recruitment Range $100,641 - $107,816 Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement. The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred: - Deep expertise in detecting and preventing fraud, waste, and abuse (FWA) within Medicaid and managed care, supported by the ability to translate data insights into actionable investigative strategies. - Proven ability to lead complex investigations, analyze evidence, prepare cases for referral, and support criminal or civil proceedings while ensuring compliance with state and federal regulations. - Demonstrated leadership experience managing large teams, overseeing vendor relationships, and fostering collaboration across internal and external stakeholders. - Skilled in building and maintaining effective partnerships with law enforcement, prosecutorial agencies, providers, and health plans, supported by exceptional written and verbal communication for reports, presentations, and negotiations. - Strong proficiency in Microsoft Office applications (Teams, Outlook, Excel, Word) with the ability to coach staff, manage performance, and coordinate high‑impact investigative and program activities. Management Preferences: - Previous work experience with a Medicaid agency. - Experience effectively managing personnel in the execution of provider audits and investigations. - Considerable knowledge of healthcare operations. - Familiarity with state of NC contracting processes, including vendor monitoring. The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries. Compensation & Benefits: The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees.

Role Description As Senior Director, Chief Compliance Officer, you will build, lead, and evolve a global compliance program that enables business growth while navigating increasingly complex regulatory environments across fintech, AI, global trade, and data privacy. You will operate as a trusted advisor to executive leadership and the Board, influencing decisions that directly impact the company’s strategy, risk posture, and long-term success. Qualifications - Experience in compliance programs across various sectors. - Strong leadership and advisory skills. - Ability to navigate complex regulatory environments. Requirements - Proven track record in compliance leadership. - Expertise in fintech, AI, global trade, and data privacy. - Strong communication and influencing skills. Benefits - Opportunity to work with diverse talents and expertise. - Engagement in business transformation and innovation. - Access to future technologies for personalized consumer experiences. Company Description The people of Diebold Nixdorf are 23,000+ teammates of diverse talents and expertise in more than 130 countries, harnessing future technologies to deliver personalized, secure consumer experiences that connect people to commerce. Our culture is fueled by our values of collaboration, decisiveness, urgency, willingness to change, and accountability. - Diebold Nixdorf is an equal opportunity employer. - We value diversity and do not discriminate based on various factors.

• Lead the development, implementation, and ongoing enhancement of the P&C compliance program. • Provide strategic compliance guidance and consultation to business leaders and stakeholders. • Foster a culture of ethics, integrity, accountability, and regulatory compliance. • Monitor emerging regulatory developments and industry trends and assess potential business impacts. • Oversee compliance with applicable federal and state insurance laws, regulations, and regulatory guidance. • Advise business partners on regulatory requirements related to claims, underwriting, product administration, producer activities, consumer protection, privacy, anti-fraud, and market conduct. • Support implementation of regulatory changes and monitor compliance with new requirements. • Coordinate responses to regulatory inquiries, examinations, and requests for information. • Identify, assess, and monitor compliance risks across the P&C business. • Partner with business areas to develop and implement effective controls and mitigation strategies. • Conduct compliance reviews, monitoring activities, and risk assessments to evaluate adherence to regulatory requirements and company standards. • Track and report compliance risks, issues, and corrective action plans. • Provide strategic oversight of the P&C Compliance team’s execution of SOX controls testing, compliance monitoring, and quality review activities, ensuring testing is completed timely, accurately, and in accordance with established methodologies and regulatory expectations. • Provide oversight of SOX compliance activities, including control design assessments, operating effectiveness testing, issue management, and coordination with Auditors, and business stakeholders. • Establish performance expectations, metrics, and reporting for compliance testing, quality reviews, and SOX activities, fostering a culture of accountability, continuous improvement, and regulatory compliance. • Provide oversight and direction to compliance team members responsible for coordinating quarterly divisional compliance meetings to help ensure accountability and timely resolution of compliance matters across the business area. • Establish and maintain processes for monitoring emerging regulatory developments, enforcement actions, emergency orders, and industry guidance impacting the P&C business, and ensuring affected business areas are informed, prepared and compliant with new or revised requirements. • Develop and maintain compliance metrics, dashboards, and reporting for leadership and governance committees. • Prepare and present compliance updates, risk assessments, and emerging issues to senior leadership. • Support governance committees and working groups focused on compliance, conduct, and fraud risk management. • Maintain documentation supporting compliance activities and oversight responsibilities. • Partner with business leaders and Special Investigations Unit (SIU) resources to support fraud prevention, detection, investigation, and reporting activities. • Provide oversight and guidance regarding fraud-related regulatory requirements, state fraud plans, reporting obligations, and anti-fraud training requirements. • Consult on OFAC Sanctions monitoring and regulatory adherence. • Support enterprise fraud and OFAC governance initiatives and cross-functional fraud and OFAC risk management efforts. • Partner with Compliance and business stakeholders to develop and deliver compliance training and awareness initiatives. • Promote understanding of regulatory requirements and compliance expectations throughout the organization. • Support role-based training programs related to claims handling, anti-fraud requirements, market conduct, and other compliance topics. • Coordinate compliance-related audits, examinations, and reviews. • Support issue management, remediation planning, and corrective action tracking. • Ensure timely resolution of compliance findings and regulatory concerns.

Role Description Performs chart assessments with focus on application and accuracy of CPT, ICD-10-CM and MIPS/QCDR codes utilized, including communication with other departments, as needed. - Performs reviews for payer specific coding application and makes recommendations or file appeals, as needed. - Assists with coding of confidential charts, as needed. - Communicates trends in errors or documentation concerns to the Coding Compliance Manager. - Participates in industry-related webinars and/or other conference calls, as needed, and summarize information. - Offers recommendations for coding program enhancement. - Reviews encounters and makes final determination of patient disputes, including communication by mail with patients, as needed. - Ensures compliance with local, state, and federal government requirements. - May be asked to travel for business purpose, not exceeding 5%. - Researches, interprets, and develops coding guidelines and methodology, including coder and client reference materials such as: Medicare, Medicaid, and workmen’s compensation guidelines for states we have not billed in, new practice lines and/or services, and new CPT codes, including possible addition of services not currently billed for. - Researches and interprets other commercial payer policies and provides guidance as needed. - Assists in reviewing information and applying periodic updates to RCM reference materials. - Evaluates literature, regulations, and payor policies and clarifies current code application and methodology, as needed. - Review and/or application of MIPS/QCDR measures. Qualifications - High School Diploma or GED equivalent required. - Two years’ minimum coding experience, or equivalent, to be able to apply correct CPT and ICD-10-CM codes in accordance with all Federal, State, and private payer statute and regulations; OR - Two years’ minimum billing experience with government payors, preferable Medicare and Medicaid. - Certified Procedural Coder (CPC) certification and/or Certified in Healthcare Compliance (CHC) certification highly desired. - Basic knowledge of pathology and etiology of disease, body areas and organ systems. - Knowledge of CPT and ICD-10-CM coding practices and/or knowledge of Medicare/Medicaid billing practices and appeal process. - Excellent communication and interpersonal skills, including conflict resolution. - Ability to communicate effectively in writing and verbally. - Computer skills including Microsoft Outlook Suite (Word, Excel, Outlook), with intermediate Excel and Word knowledge. - Ability to review literature and come to conclusions and make recommendations to coding management. - Ability to analyze new or ambiguous information, define the issue or problem and propose resolution. - Strong organizational skills and ability to meet deadlines. - Ability to handle a fast-paced, high production environment. - Strong consultation skills and the ability to seek out information and provide quality advice. - Strong research skills with ability to apply complex reasoning and analysis to identify best policy proposal or interpretation. - Ability to work independently, accomplish responsibilities timely, meet acceptable productivity requirements to ensure appropriate workflow. - Ability to maintain effective working relationships with all staff. - Ability to react to change productively. Benefits - Superior health plan options. - Dental, Vision, HSA/FSA, Life and AD&D coverage, and more. - Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6% plus discretionary profit-sharing contributions (eligible January following 18 months of service). - Generous paid time off starting 3-4 weeks’ annually. - Student Loan Refinancing Discounts. - Professional and Career Development Program. - EAP and travel assistance included. - Wellness program. - Purpose-driven culture focused on improving the lives of our patients, communities, and employees.