Clinical Compliance Director

About Vitra Health

Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs— supported by a Nurse, and Case Manager, Vitra ensures clients receive compassionate, personalized, and dignified care.

To help share our mission and expand our community impact, Vitra Health is seeking a Clinical Compliance Director who is passionate about community engagement and helping people access the care and resources they deserve.

The Opportunity

The Director of Clinical Compliance is a senior leadership role responsible for developing, implementing, and overseeing Vitra Health's comprehensive compliance strategy across all clinical programs and operations.

Reporting directly to the Vice President of Quality and Compliance, the Director serves as the organization's subject matter expert on healthcare compliance and regulatory affairs while providing strategic leadership for compliance risk management, audit readiness, regulatory governance, and quality oversight.

This role leads the compliance team, partners closely with executive leadership, and influences organizational decision-making to ensure ongoing compliance with state and federal regulations while advancing a culture of ethical conduct, accountability, and continuous improvement.

The Director will oversee compliance activities across AFC, GAFC, ADH, and future program lines, ensuring sustainable compliance frameworks that support organizational growth and operational excellence.

Key Responsibilities

Compliance Strategy & Governance

• Develop and execute the organization's enterprise-wide clinical compliance strategy aligned with organizational goals and regulatory requirements.
• Provide strategic leadership for compliance governance, risk management, and regulatory oversight across all service lines.
• Serve as the organization's primary compliance authority and advisor to executive leadership.
• Establish long-term compliance objectives, metrics, and performance indicators.
• Lead annual enterprise compliance risk assessments and develop corresponding mitigation strategies.
• Ensure organizational readiness for regulatory audits, accreditation reviews, and government investigations.
• Present compliance trends, risks, and performance updates to executive leadership and governing bodies.
• Evaluate emerging regulatory changes and proactively lead organizational implementation efforts.

Regulatory Compliance & Risk Management

• Oversee all compliance monitoring, auditing, investigation, and corrective action activities.
• Direct enterprise risk assessments relating to clinical operations, documentation, billing integrity, and service delivery.
• Lead organizational responses to regulatory findings, external audits, and compliance investigations.
• Establish systems for identifying, tracking, and mitigating compliance risks throughout the organization.
• Ensure compliance with CMS, MassHealth, HIPAA, OIG guidance, and other applicable federal and state regulations.
• Provide executive oversight of corrective and preventive action plans (CAPA) and ongoing monitoring activities.
• Ensure appropriate escalation and resolution of high-risk compliance matters.
• Partner with Legal, Operations, Clinical Services, and Human Resources on regulatory and compliance initiatives.

Leadership & Team Development

• Lead, mentor, and develop a high-performing compliance team, including managers, auditors, compliance specialists, and clinical reviewers.
• Establish departmental goals, succession planning initiatives, and workforce development strategies.
• Foster a culture of accountability, continuous improvement, ethical conduct, and operational excellence.
• Guide leaders across departments in implementing compliance-related initiatives.
• Build organizational compliance capabilities through coaching, education, and leadership development.
• Develop department budgets and ensure effective allocation of compliance resources.

Enterprise Audit & Quality Oversight

• Provide executive oversight of internal audit programs, clinical documentation reviews, and quality monitoring activities.
• Ensure data-driven evaluation of compliance performance and organizational risk trends.
• Direct development and maintenance of compliance dashboards, scorecards, and executive reporting tools.
• Monitor effectiveness of compliance remediation efforts and identify opportunities for systemic improvement.
• Collaborate with Quality leadership to align compliance initiatives with quality improvement strategies.
• Ensure audit findings are translated into measurable operational improvements.

Regulatory Education & Organizational Influence

• Develop and oversee organization-wide compliance education and training programs.
• Serve as a strategic resource to operational leaders and clinical departments regarding compliance requirements and best practices.
• Lead enterprise communication efforts related to regulatory updates and organizational compliance initiatives.
• Promote a culture of integrity, transparency, and regulatory excellence across Vitra Health.
• Represent the organization with regulatory agencies, payers, industry associations, and external stakeholders.

What we are looking for:

• Active Massachusetts Registered Nurse (RN) license.
• Bachelor's degree in Nursing required; Master's degree strongly preferred.
• 10+ years of progressive healthcare compliance, clinical operations, quality, regulatory affairs, or risk management experience.
• 5+ years of leadership experience managing compliance, quality, audit, or regulatory teams.
• Demonstrated experience developing and leading enterprise compliance programs.
• Extensive knowledge of Medicare, Medicaid, MassHealth, AFC, GAFC, and Adult Day Health regulations.
• Proven track record of leading successful regulatory audits, investigations, and corrective action initiatives.
• Strong executive presence with the ability to influence leaders at all organizational levels

Preferred Qualifications

• Master's degree in Nursing, Healthcare Administration, Public Health, Regulatory Affairs, or related field.
• Experience leading, managing, or supporting NCQA Accreditation preparation, survey activities, and ongoing compliance maintenance strongly preferred
• Certified in Healthcare Compliance (CHC).
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar certification.
• Experience within home care, community-based services, long-term care, or managed care environments.
• Experience presenting to executive leadership teams and Boards of Directors.

Work Environment and Physical Requirements

• Office-based work in a clean well-lit environment with fluctuating temperatures near others.
• Client-facing field staff and community liaisons require frequent travel to client homes or community settings; ability to drive safely; work in client homes may involve varying temperatures, odors, allergens, pets, and other environmental factors.
• Requires substantial periods of repetitive work utilizing a computer, monitor, keyboard, and mouse.
• Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.

Perks and Benefits:

• Employer sponsored health Insurance with a generous employer match.
• Dental and Vision Benefits.
• Supplemental Benefits
• Life, Accident, Critical Illness and Disability Insurance.
• 401K with a 5% company match.
• Accrued Paid-Time-Off.
• Ten company paid holidays.
• Wellness Benefits.
• Tuition Reimbursement.
• Supportive team structure and company culture with a focus on work/life balance.

Vitra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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