Chief Compliance Officer

COMPANY:
A leading nonprofit provider of disability, behavioral health, and community-based support services.

REPORTS/RELATIONSHIPS:
This position will report directly to the Chief Executive Officer and is a critical member of the executive leadership team.

BASIC FUNCTIONS:
The Chief Compliance Officer (CCO) serves as a strategic partner and content expert to the Chief Executive Officer, providing compliance leadership and ethical stewardship to ensure the long-term integrity and mission success of the company. The CCO oversees all aspects of the enterprise-wide compliance program, including regulatory adherence, risk management, privacy and data security, billing integrity, and organizational ethics. This role also leads quality management and directs staff in developing plans to address compliance issues in a timely manner, overseeing accreditation, quality assurance and improvement activities, staff development and training, and monitoring and evaluation of program activities. This position ensures the organization maintains full compliance with applicable federal and state regulations, accreditation standards, and funding requirements across its diverse payer and program landscape. The CCO leads with a mission-driven, proactive approach to risk identification, staff education, and organizational accountability.

Specific duties will include, but not necessarily be limited to:

Partner with the CEO and executive team to develop and execute a comprehensive compliance strategy that advances the organization’s mission and protects its integrity.
Serve as the primary liaison to regulatory agencies, accreditation bodies, managed care organizations, and state and federal oversight entities in North Carolina and Virginia.
Maintain deep expertise in behavioral health, disability services, substance use disorder treatment, and Medicaid/Medicare compliance requirements in a dual-state environment.
Design, implement, and continuously improve enterprise-wide compliance program and standards of conduct; ensure effective communication and understanding across the workforce to build a culture of compliance and ethical conduct.
Establish and enforce compliance policies and procedures across all programs and departments. Translate and interpret policy actions and communicate their impact on service delivery to all program staff.
Act in a consultative role to the Cybersecurity Team as needed for policy development and practices to meet all regulatory requirements for client and organization data.
Recommend to the CEO when to consult outside legal counsel on specific complaints, actions, or findings that require legal interpretation or intervention.
Oversee the Compliance Committee and the functions of the Quality Management Committees across all operating regions.
Lead regular compliance risk assessments across clinical operations, billing and coding, privacy and security, employment practices, and financial management.
Direct and oversee internal compliance audits, investigations, and monitoring activities, including post-billing audits in conjunction with the Corporate Compliance Committee; develop corrective action plans and track remediation through to completion.
Coordinate organizational responses to external audits, government investigations, and third-party reviews; manage relationships with external counsel and compliance consultants.
Negotiate settlements with funding agencies on disputed claims and policy out-of-compliance findings.
Oversee compliance monitoring of billing and coding practices across all Medicaid, Medicare, commercial, and contract-funded programs to prevent fraud, waste, and abuse.
Develop, with input from stakeholder groups, the organization’s annual Quality Management Plan, including quality assurance and improvement activities.
Facilitate and coordinate accreditation activities; ensure ongoing readiness for CARF, The Joint Commission, and other applicable accreditation bodies.
Responsible for notifying Board Chair in the event of a compliance breach or serious incident in which the CEO or other officers may be involved or complicit.

REQUIREMENTS:

Minimum of 15 years of progressive compliance, regulatory, or risk management experience in a healthcare or behavioral health setting, with a focus on mental health, intellectual and developmental disabilities, and substance use services; experience managing compliance in a complex, multi-site organization is strongly preferred.
Significant experience with Medicaid, Medicare, and state-funded behavioral health programs; dual-state (NC and VA) regulatory experience preferred.
Deep expertise in HIPAA, 42 CFR Part 2, behavioral health and substance use disorder regulations, Medicaid managed care requirements, and nonprofit governance standards; knowledge of national accreditation requirements (CARF, The Joint Commission, or comparable).
Demonstrated ability to negotiate effectively on state and federal policy matters, with considerable industry contacts and knowledge of the history and development of service and support systems.
Track record of successfully managing government audits, regulatory inquiries, investigations, and disputed claims settlements.
Exceptional communicator with the ability to translate complex regulatory requirements into clear, actionable guidance for audiences ranging from frontline staff to the Board of Directors.
Strategic thinker who anticipates regulatory risk, leverages data and monitoring to guide the organization forward, and keeps long-range mission outcomes in view.
Collaborative leader who builds trust and accountability across clinical, operational, finance, and legal functions; guides and develops staff through clear expectations, coaching, and meaningful feedback.
Mission-driven with a deep commitment to advancing inclusive healthcare and human services.
Ability to travel across North Carolina and Virginia, and nationally as needed.
Bachelor’s degree in a healthcare or closely related field is required; advanced degree preferred.

COMPENSATION:
Compensation will be commensurate with experience, including a competitive salary and benefits package.

CONTACT INFORMATION:
Joy Abbott, Consultant
jabbott@CLCBsearch.com
704.377.0362