Head of Compliance (Part-Time)

The role

The Head of Compliance will own the regulatory posture for a PC-MSO. This person will set policies, review work, train the team, and manage compliance for structure, HIPAA, coding, billing, and revenue cycle.

What you will do

• Keep the PC-MSO arrangement compliant regarding management services agreements and state rules.
• Own the HIPAA privacy and security program including risk assessments and workforce training.
• Audit Medicare codes against documentation and time requirements.
• Review revenue cycle practices including eligibility, claims, denials, and appeals.
• Track regulatory changes from CMS, OIG, and payers.
• Ensure compliance with Anti-Kickback Statute, Stark, and the False Claims Act.
• Build and run a compliance program based on OIG General Compliance Program Guidance.

Required qualifications

• 7+ years in healthcare compliance, with Medicare Part B billing and coding at the center of it.
• Hands-on experience with a PC-MSO or similar physician-practice management structure.
• Deep working knowledge of HIPAA, the Anti-Kickback Statute, Stark, and the False Claims Act.
• Experience with revenue cycle operations: claims, denials, appeals, patient cost-sharing, and overpayment refunds.

Nice to have

• Certification such as CHC, CHPC, CPC or CPCO.
• Experience with care management (CCM, PCM, APCM, BHI), remote monitoring, or telehealth services.
• Experience with Medicare Advantage and Medicaid managed care plans across multiple states.
• JD, or experience working closely with healthcare counsel.

About the company

Mira Mace is a venture-backed company helping Medicare patients navigate the healthcare system. The team has built products and care at places like Google, Meta, Amazon, Landmark Health, and Parsley Health.