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Compliance Officer

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Job Description - Compliance Officer



Position Summary


The Compliance Officer is responsible for overseeing and managing the legal and regulatory compliance framework of the organization. 


This role requires advanced legal knowledge to ensure the company’s operations comply with federal and state healthcare regulations, 


contractual obligations, and corporate governance requirements.


The Compliance Officer will design, implement, and monitor compliance programs relating to healthcare services, caregiver credentialing, client agreements, vendor contracts, payer agreements, and regulatory obligations governing healthcare providers. The position requires the application of legal analysis, statutory interpretation, contract law, and regulatory compliance expertise.


Due to the legal complexity of healthcare regulations, contract negotiation, and risk management responsibilities, this role requires an individual with a Juris Doctor (JD) degree and admission to the bar.


Key Responsibilities


1. Legal and Contract Compliance


• Draft, review, and negotiate contracts with clients, healthcare facilities, insurance companies, referral partners, and vendors.


• Ensure all contractual agreements comply with applicable healthcare regulations, federal law, and state law.


• Manage and maintain the organization’s contract database and ensure proper documentation and renewal processes.


• Review franchise agreements, assignments, and transfer agreements related to the company’s healthcare operations.


• Monitor compliance with contractual obligations under agreements with franchisors and other business partners.


2. Healthcare Regulatory Compliance


• Interpret and implement regulatory requirements applicable to healthcare service providers including HIPAA, federal healthcare fraud and abuse laws, Stark Law, AntiKickback Statute, and state home healthcare licensing requirements.


• Develop internal compliance policies for patient services, caregiver conduct, and client documentation.


• Ensure company operations adhere to healthcare industry standards and regulatory requirements.


3. Caregiver and Clinical Compliance


• Oversee compliance for healthcare staff including registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), and caregivers.


• Verify credentialing, licenses, training certifications, and background checks required by law.


• Ensure caregivers meet all state and federal compliance requirements before assignment to clients.


• Develop and implement compliance training programs for healthcare staff.


4. Client and Patient Compliance


• Ensure client intake procedures comply with healthcare regulations and privacy requirements.


• Monitor documentation standards for patient care records, service agreements, and consent forms.


• Review compliance related to billing practices, insurance eligibility, and payer agreements.


• Investigate and resolve compliance issues involving patient services or contractual obligations.


5. Risk Management and Internal Auditing


• Conduct regular compliance audits across operations, contracts, and caregiver documentation.


• Identify potential legal or regulatory risks and develop mitigation strategies.


• Lead internal investigations relating to compliance violations or regulatory concerns.


• Prepare compliance reports and recommendations for executive leadership.


6. Corporate Governance and Policy Development


• Develop company-wide compliance policies and procedures.


• Maintain documentation required by regulators and franchisors.


• Provide legal guidance to management regarding business practices and regulatory requirements.


7. Regulatory Reporting and Government Relations


• Prepare documentation required for regulatory audits and licensing reviews.


• Interface with government agencies, regulatory authorities, and external legal counsel when necessary.


• Ensure timely submission of compliance reports, certifications, and licensing documentation.


Required Qualifications


Education


• Juris Doctor (JD) degree from an accredited law school.


Licensure


• Must have passed a U.S. state bar examination.


• Must be licensed to practice law in Alabama.


• Must maintain active bar membership in good standing throughout employment.


Experience


• Experience reviewing legal contracts, regulatory policies, or compliance frameworks preferred.


• Knowledge of healthcare regulations, corporate compliance programs, or risk management preferred.


Skills


• Advanced legal research and analysis


• Contract drafting and negotiation


• Regulatory interpretation and compliance program development


• Strong written and verbal communication


• Risk assessment and problem-solving


Specialized Knowledge


This position requires specialized knowledge obtained through a Juris Doctor degree in areas including contract law, corporate governance, regulatory compliance, healthcare law, and risk management. The complexity of healthcare regulatory frameworks and contractual obligations requires advanced legal training to ensure the organization maintains compliance with applicable laws and regulations.




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