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Director, Compliance
Columbia University Medical Center is hiring for the role of Director, Compliance, New York, NY (On-site). This is a Compliance role in the governance, risk, and compliance field, with a posted range of $150,000 - $160,000. Review the full details below and apply directly with Columbia University Medical Center.
The Director of Compliance is a leadership role within the Compliance Department responsible for overseeing and advancing the organization's professional fee compliance, billing integrity, and regulatory adherence programs. This position directs a broad and comprehensive academic medical center compliance program, ensuring compliance with CMS regulations, federal and state laws, and applicable coding guidelines.
The Director contributes to the success of CUIMC's mission, provides strategic direction and operational leadership for a team of compliance professionals, supports provider education and dispute resolution, and partners closely with Revenue Cycle, Clinical Departments, Legal, and Leadership to mitigate risk and promote compliant billing practices across a large academic medical center.
Compliance Program Leadership: Support the Chief Compliance Officer in advancing CUIMC's Compliance Program. Monitor the program, including reporting metrics, and develop regular reporting materials for the Clinical Compliance Committee and Board. Represent Compliance on University committees including the Ambulatory Care Network and Tripartite Compliance Committee. Lead and develop a team of compliance professionals (auditors, analysts, educators), setting priorities aligned with organizational risk. Oversee audit program design and execution, including statistically valid sampling, targeted audits, and corrective action plans.
Revenue Integrity and Regulatory Expertise: Serve as the final decision-maker on complex coding, billing, and documentation issues, including interpretation of CMS regulations, NCCI edits, LCDs/NCDs, CPT/AMA guidelines, and payer policies. Provide authoritative guidance on professional fee billing, including global surgical package rules, modifier usage, incident-to services, and split/shared services. Monitor and interpret evolving federal and state regulations and translate requirements into actionable compliance strategies.
Audit, Monitoring, and Systems Expertise: Design and implement a risk-based technical and professional billing compliance auditing program. Provide oversight of audit tools and technologies, ensuring effective use of audit software platforms and data analytics tools. Leverage EPIC EHR expertise to support audit workflows, documentation review, and reporting. Partner with Departmental and Revenue Cycle teams to enhance system controls, edits, and compliance-related configurations. Analyze audit and billing data trends to identify systemic risks and opportunities for improvement.
Provider Engagement and Dispute Resolution: Facilitate resolution of complex or sensitive issues with physicians and clinical leadership, balancing compliance requirements with operational realities and delivering clear, credible, diplomatically communicated guidance to gain provider alignment.
Education, Communication, and Strategic Leadership: Prepare and oversee employee training programs and materials so that staff at all levels are aware of compliance guidelines. Develop and deliver compliance education to physicians, departments, and leadership on compliance risks and regulatory updates. Partner with senior leaders across Compliance, Revenue Cycle, Legal, and Clinical Departments to align on enterprise risk priorities, and support external audits, regulatory inquiries, and investigations as needed.
Qualifications
- Bachelor's degree required; advanced degree (MHA, MBA, MPH) strongly preferred
- CHC (Certified in Healthcare Compliance) or CHC-related credential
- CPC, CCS-P, or equivalent coding certification
- 10+ years of progressive healthcare compliance, coding, or revenue integrity experience, including 5 years in a leadership or management role, preferably within an academic medical center or large physician enterprise
- Deep expertise in CMS regulations and reimbursement methodologies, CPT/HCPCS coding guidelines, and professional fee billing compliance
- Expert-level proficiency in EPIC EHR (reporting, documentation review, audit workflows); Epic certification preferred
- Expert knowledge of audit and compliance software tools (Audit Manager, MD Audit) and data analytics platforms
- Expert knowledge of HHS OIG General Compliance Program Guidance, the DOJ Evaluation of Corporate Compliance Programs, and fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act)
Location and market context
This role is based in New York on-site. Local candidates benefit from being close to Columbia University Medical Center's teams and regional hiring market. Confirm the exact in-office expectation and any relocation support with the employer.
About compliance roles
Compliance programs turn law, regulation, and policy into controls the business can actually run. Demand is strongest where regulatory change, enforcement risk, and new technology intersect. Roles like this one are typically evaluated against frameworks such as relevant regulatory frameworks, control libraries, and audit and monitoring practices.
How to position yourself for this compliance role
Strong candidates emphasize building and monitoring controls, regulatory mapping, policy and training, and partnering with the business to make compliance practical. In your resume and outreach, tie your experience to how Columbia University Medical Center would apply relevant regulatory frameworks, control libraries, and audit and monitoring practices, and lead with concrete outcomes rather than duties.
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