Compliance Officer

Description

Position Summary: 

The Compliance Officer leads and administers Waterfall Community Health Center's organization-wide Corporate Compliance Program. The position functions as an independent and objective resource that promotes ethical conduct, evaluates compliance concerns, and supports adherence to applicable federal and state laws, regulations, grant and contract requirements, HRSA Health Center Program requirements, Federal Tort Claims Act (FTCA) requirements, and organizational policies and standards of conduct. 

Reporting to the Chief Executive Officer and maintaining direct and independent access to the Board of Directors, the Compliance Officer advises leadership and the Board on compliance risks, program effectiveness, investigations, clinical risk management, corrective actions, and emerging regulatory requirements. The position coordinates closely with operational and clinical leadership, Human Resources, Finance, Revenue Cycle, Quality, Risk Management, Information Technology, legal counsel, and other departments to integrate compliance into organizational operations and decision-making.

Essential Responsibilities: 

Compliance Program Leadership and Governance 

• Lead the development, implementation, maintenance, and periodic evaluation of the Corporate Compliance Program and annual compliance work plan in alignment with applicable regulatory guidance and recognized elements of an effective compliance program. 
• Develop, maintain, and oversee compliance policies, procedures, internal controls, and reporting processes in collaboration with responsible leaders. 
• Advise the CEO, executive leadership, managers, and Board of Directors on compliance obligations, identified risks, investigations, corrective actions, program priorities, and recommended actions. 
• Maintain direct and independent access to the Board of Directors, promptly escalate significant compliance matters, and provide regular written and verbal reports regarding program activities and effectiveness. 
• Monitor changes in healthcare laws, regulations, enforcement priorities, grant conditions, payer requirements, an organizational obligation; communicate relevant changes and coordinate implementation. 
• Coordinate with legal counsel on complex legal or regulatory matters and maintain organized, accurate, secure, and complete records of compliance activities, findings, decisions, investigations, training, and corrective actions. 

HRSA FQHC Compliance: 

• Monitor organizational compliance with HRSA Health Center Program requirements, FTCA requirements, federal grants, Medicare, Medicaid, fraud, waste and abuse requirements, applicable state requirements, payer obligations, and other regulatory or contractual commitments. 
• Serve as a primary compliance resource for HRSA Operational Site Visits, grant reviews, audits, and other regulatory examinations, including preparation, document collection, response development, corrective action, and follow-up. 
• Coordinate compliance activities associated with FTCA deeming and redeeming applications, risk management requirements, claims reporting, and related documentation. 

Compliance Reporting, Investigation, and Corrective Action: 

• Establish, administer, and promote confidential reporting mechanisms, and reinforce the organization's non-retaliation expectations. 
• Receive, triage, document, investigate, and resolve reports of suspected violations of laws, regulations, policies, procedures, contractual obligations, or Standards of Conduct and conduct fair, timely investigations and root cause analyses. 
• Identify compliance vulnerabilities and root causes; mitigate risk across the organization; and develop or recommend corrective and preventive action plans and monitor their completion and effectiveness. 
• Escalate unresolved, recurring, or material issues to appropriate leadership and the Board and coordinate external reporting when required or appropriate, in consultation with leadership and legal counsel. 

Risk Management and Claims Coordination: 

• Serve as the organization's designated Risk Manager, unless otherwise assigned, and oversee implementation and ongoing evaluation of the risk management plan. 
• Coordinate organization-wide risk identification, assessment, mitigation, and monitoring in collaboration with clinical, quality, and operational leaders. 
• Oversee or support incident reporting, event review, root cause analysis, patient complaint and grievance oversight, trend analysis, and development of risk-reduction strategies. 
• Coordinate liability claims, potentially compensable events, and required reporting with FTCA, insurers, legal counsel, and organizational leadership, as appropriate. 
• Provide regular risk management reports to executive leadership and the Board and participate in committees related to compliance, risk, quality, patient safety, or other organizational priorities. 

Education, Communication and Culture: 

• Develop and oversee an effective compliance education and communication program for employees, contractors, volunteers, leadership, and the Board, as appropriate. 
• Coordinate compliance orientation, annual training, role-based education, and ongoing communications in partnership with Human Resources and department leaders. 
• Promote awareness of the Standards of Conduct, reporting channels, non-retaliation protections, and key compliance obligations. 
• Provide practical guidance and resources to help departments apply compliance requirements and foster a culture of integrity, accountability, respectful communication, and continuous improvement. 
• Serve as a trusted and objective resource for employees and leaders seeking guidance on ethical or compliance-related concerns. 

Organizational Leadership and Personnel Management: 

• Partner with Quality, Operations, Finance, Revenue Cycle, Human Resources, Information Technology, and clinical leadership to integrate compliance into organizational operations, strategic initiatives, and decision-making. 
• Provide leadership, supervision, coaching, work planning, and performance management for assigned compliance staff, if applicable. 
• Establish clear priorities, responsibilities, and performance expectations; support staff development, cross-training, accountability, and continuity of essential compliance functions. 
• Represent Waterfall at meetings, trainings, conferences, audits, and external reviews, as applicable, and maintain current professional knowledge through continuing education and regulatory updates. 
• Perform other duties consistent with the purpose, authority, and independence of the Compliance Officer role.

Knowledge, Skills and Abilities: 

• Advanced knowledge of healthcare compliance principles and applicable federal and state laws, regulations, and standards. 
• Working knowledge of HRSA Health Center Program requirements, FQHC operations, FTCA, Medicare and Medicaid requirements, fraud, waste and abuse prevention, federal grant compliance, healthcare billing and coding, and risk management. 
• Ability to interpret complex legal and regulatory requirements and translate them into practical organizational guidance, policies, processes, and controls. 
• Demonstrated ability to conduct investigations, evaluate evidence, reach objective conclusions, and prepare clear written findings and recommendations. 
• Ability to collect, analyze, interpret, and present qualitative and quantitative information to executive leadership and the Board. 
• Excellent written, verbal, presentation, facilitation, and interpersonal communication skills. 
• Ability to exercise independent judgment, maintain appropriate professional skepticism, manage sensitive matters, and escalate concerns when necessary. 
• Ability to influence stakeholders, coordinate cross-functional work, manage competing priorities, and complete time-sensitive projects. 
• High degree of integrity, professionalism, discretion, accountability, and business ethics. 
• Proficiency with Microsoft Office applications and familiarity with electronic health records, reporting, compliance tracking, incident reporting, learning management, and document management systems. 
• Ability to work effectively with a diverse workforce, patient population, leadership team, Board of Directors, regulators, vendors, and community partners.

Location: ONSITE, Reports to the North Bend office, requires travel to other Waterfall sites

Status & Schedule: FULL-TIME, MONDAY – FRIDAY, 8AM – 5PM

Requirements

Education and/or Experience and Qualifications: 

• Bachelor’s degree in healthcare administration, public health, business administration, accounting, finance, law, clinical services, or a related field required; master’s degree or Juris Doctor preferred. 
• Minimum of five years of progressively responsible healthcare compliance, auditing, risk management, legal, financial, or healthcare operations experience required; seven or more years preferred. 
• Prior experience in an FQHC, community health center, or other highly regulated healthcare environment strongly preferred. 
• Demonstrated experience developing or administering a compliance program, conducting investigations, coordinating audits, and implementing corrective action plans. 
• Experience with HRSA requirements, FTCA risk management, federal grants, Medicare, Medicaid, or healthcare billing compliance strongly preferred. 
• Experience presenting to executive leadership and a Board of Directors preferred. 
• Healthcare compliance certification, such as Certified in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional (CCEP), or comparable credential, preferred or willingness to obtain within an agreed timeframe. 
• Valid driver’s license, reliable transportation, acceptable driving record, and insurance coverage required for travel between sites. 
• Required organizational training, certifications, health screenings, and immunizations must be completed and maintained in accordance with Waterfall policy and applicable requirements. 

Immunizations Required: 

• TB (test upon hire)  

Physical Requirements: 

• Prolonged periods sitting at a desk working at a computer. 
• Able to lift 15 pounds occasionally. 
• Able to travel as needed.