Compliance Counsel

Overview

This role involves providing legal and regulatory guidance within the healthcare sector, focusing on compliance with federal and state healthcare laws. The position supports patients navigating complex healthcare systems by ensuring the organization's operations align with healthcare regulations, including Medicare, Medicaid, HIPAA, and other privacy laws.

Responsibilities

• Provide legal and regulatory analysis on HIPAA, Medicare, Medicaid, and state healthcare requirements, translating complex regulations into clear guidance for business and operational teams.
• Collaborate with the Director of Compliance to assess regulatory risks, develop compliance strategies, and advise on emerging issues related to products, services, and operations.
• Advise cross-functional teams such as Product, Engineering, Clinical Operations, Revenue Cycle, and Provider Operations on compliance requirements for new initiatives prior to launch.
• Conduct compliance reviews, audits, and monitoring activities related to Medicare, payer programs, HIPAA, and other healthcare regulations, including evidence collection, documentation review, issue identification, and remediation planning.
• Draft and maintain compliance policies, procedures, playbooks, and training materials reflecting regulatory requirements and evolving business practices.
• Integrate compliance requirements into operational processes, product workflows, and system controls by working closely with business and technical stakeholders.
• Review vendor agreements, business associate agreements, and other commercial contracts for healthcare regulatory and compliance considerations.
• Support investigations, risk assessments, and remediation efforts involving potential compliance concerns such as billing, documentation, privacy, and operational issues.
• Monitor and research regulatory developments, CMS guidance, state healthcare regulations, and enforcement trends, translating their impact into actionable recommendations.
• Assist in developing and continuously improving the compliance program, including risk assessments, monitoring plans, reporting, and governance activities.

Requirements

• Juris Doctor (J.D.) degree and active bar admission in at least one U.S. state.
• 3 to 6 years of experience in compliance or regulatory legal practice, preferably in healthcare compliance.
• Ability to operate effectively in ambiguous environments where regulations and business models are evolving.
• Experience supporting audits, investigations, monitoring activities, and compliance program operations.
• Strong judgment balancing legal risk, regulatory integrity, and business needs.
• Detail-oriented with a practical approach to achieving goals.
• Must be based in the United States.

Preferred Qualifications

• Familiarity with CMS programs, Medicare billing requirements, healthcare documentation standards, or healthcare privacy law.

Compensation & Benefits

Details about compensation and benefits are not provided in the description.

Location

Applicants must be based in the United States.