Eye Health America · 1 week ago
Compliance Director
United States
Full-time
Remote
Director/Executive
8+ years expEye Health America is a rapidly expanding eye care platform seeking a Compliance Director to oversee compliance functions and ensure adherence to regulatory standards. The role involves leading internal investigations, managing the whistleblower response program, and collaborating with the executive team to maintain ethical practices during growth initiatives.
Health CareMedicalMedical Device
Responsibilities
Whistleblower Program Oversight: Assume immediate leadership of the organization’s ethics hotline and reporting mechanisms; ensure all reports are triaged, investigated, and documented with the highest level of confidentiality and professional rigor
Internal Investigations: Lead and conduct complex internal investigations into allegations of fraud, waste, abuse, or misconduct; coordinate with external legal counsel where necessary to maintain attorney-client privilege
Corrective Action & Remediation: Design and execute formal Corrective Action Plans (CAPs) to address systemic failures identified by whistleblower reports or audits, ensuring long-term prevention of recurrence
Anti-Retaliation Leadership: Establish and champion a robust non-retaliation policy and a "Speak Up" culture to rebuild employee trust and psychological safety following compliance incidents
Specialized Legal Compliance: Ensure the organization’s physician compensation, co-management agreements, and marketing practices strictly adhere to the Anti-Kickback Statute (AKS), Stark Law, and the False Claims Act (FCA)
Clinical Compliance & Eye Care Standards: Collaborate with the CMO to ensure medical necessity and documentation standards for high-volume procedures (e.g., cataract surgery, premium IOLs, intravitreal injections) meet Medicare and commercial payer requirements
Revenue Cycle Compliance: Partner with the RCM department to conduct regular "probe audits" on billing and coding practices to identify and mitigate risks of overpayment or fraudulent billing
HIPAA & Privacy Officer Duties: Serve as the Privacy Officer, overseeing the protection of PHI and managing the response to any potential data breaches or HIPAA violations
M&A Due Diligence: Perform comprehensive compliance due diligence on potential acquisitions, identifying historical liabilities and "red flag" referral patterns before closing
Post-Acquisition Integration: Lead the rapid "compliance onboarding" of newly acquired clinics, standardizing their policies, training, and reporting structures under the corporate umbrella
Board & Sponsor Reporting: Develop and present executive-level risk dashboards and compliance KPIs for the Board of Directors highlighting EBITDA-impacting risks
Seven Elements Implementation: Ensure the compliance program meets the Office of Inspector General’s (OIG) "Seven Elements of an Effective Compliance Program
Risk-Based Auditing: Design and implement an annual internal audit plan focused on high-risk areas identified through data analytics and previous whistleblower concerns
Policies & Procedures: Update and maintain the company’s Compliance Manual that translates complex federal and state regulations into clear, actionable operational workflows
Education & Training: Design and deliver specialized compliance training tailored to different roles (e.g., surgeons vs. front-desk staff), ensuring 100% completion rates and verified understanding of ethical obligations
Continuous Monitoring: Establish a testing program to monitor the effectiveness of internal controls and the "health" of the organization’s compliance culture
Cross-Functional Collaboration: Serve as a key member of the senior leadership team, providing compliance-focused guidance to Operations, HR, Finance, and Marketing to ensure a cohesive, unified approach to growth
Qualification
Required
8+ years of healthcare compliance experience, with at least 3 years in a leadership role (Director level or above)
Strong analytical and problem-solving skills
Excellent communication and interpersonal skills
Ability to collaborate effectively with cross-functional teams
Detail-oriented with a commitment to accuracy and thoroughness
Integrity and a commitment to ethical business practices
Preferred
Bachelor's or Master's degree in healthcare administration, Business or Law
CHC (Certified in Healthcare Compliance)
Proven track record of managing internal investigations or responding to government inquiries (OIG/DOJ)
Company
Eye Health America
EHA is an eye care practice management company.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
LLR Partners
2018-03-01Private Equity
Leadership Team
Cathleen McCabe
Chief Medical Officer
Philip Isham, COE, OCS
Chief Development Officer
Recent News
2025-05-04
Company data provided by crunchbase