Director, Compliance

Responsibilities

• Support the Chief Compliance Officer in advancing the CUIMC Compliance Program and monitoring reporting metrics.
• Lead and develop a team of compliance professionals, including auditors, analysts, and educators.
• Oversee audit program design and execution, including statistically valid sampling and corrective action plans.
• Serve as the final decision-maker on complex coding, billing, and documentation issues regarding CMS regulations and payer policies.
• Design and implement risk-based technical and professional billing compliance auditing programs.
• Leverage EPIC EHR to support audit workflows, documentation review, and reporting capabilities.
• Facilitate resolution of complex or sensitive issues with physicians and clinical leadership.
• Develop and deliver compliance education to physicians, departments, and leadership.

Requirements

• Bachelor's degree required; advanced degree (MHA, MBA, MPH) strongly preferred.
• CHC (Certified in Healthcare Compliance) or a related credential.
• CPC, CCS-P, or equivalent coding certification.
• 10+ years of progressive healthcare compliance, coding, or revenue integrity experience.
• 5+ years of leadership or management experience, preferably within an academic medical center.
• Deep expertise in CMS regulations, reimbursement methodologies, and professional fee billing compliance.
• Expert-level proficiency in EPIC EHR (reporting, documentation review, audit workflows).
• Strong knowledge of fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).

Preferred Qualifications

• CPMA (Certified Medical Professional Auditor).
• Epic certification.

About the Company

Columbia University Medical Center (CUIMC) is a leading academic medical center dedicated to providing exceptional patient care, conducting groundbreaking research, and training the next generation of healthcare professionals.