VP Chief Compliance Officer
Spire Orthopedic Partners · MSO Corporate 1000 - Stamford, CT 06905
What you’ll do:
The Vice President, Compliance is the senior executive responsible for the independent leadership, administration, and continuous improvement of the Spire Orthopedic Partners enterprise Compliance and Privacy Program. Supporting a multi-state, multi-practice healthcare Management Services Organization, outpatient orthopedic specialty practices, ancillary services, and Ambulatory Surgery Centers, this leader establishes a risk-based framework to prevent, detect, investigate, and remediate conduct inconsistent with law, regulation, contractual requirements, organizational policy, or ethical standards. The Vice President reports directly to the Chief Executive Officer and has direct, unrestricted access to the appropriate governing body or committee for significant compliance matters. The role partners closely with clinical, operational, revenue cycle, finance, legal, human resources, information technology, security, and physician leadership while maintaining the authority, visibility, resources, and independence required for an effective compliance function.
Responsibilities/Duties:
- Set the enterprise compliance and privacy strategy and lead the design, implementation, evaluation, and continuous improvement of the Compliance Program across all Spire Orthopedic Partners entities, supported practices, ancillary services, and Ambulatory Surgery Centers.
- Serve as a strategic and independent advisor to the Chief Executive Officer, Executive Leadership Team, physician leaders, and the appropriate governing body or committee; report regularly on priority risks, investigations, audit results, corrective actions, emerging requirements, and overall program effectiveness.
- Chair or lead the enterprise compliance committee and establish clear accountability, escalation, documentation, and decision-making processes across operating entities, markets, practices, and facilities.
- Lead the enterprise compliance risk assessment and annual work-planning process, maintaining a prioritized risk register and mitigation plans for regulatory, billing, coding, reimbursement, privacy, security, operational, financial, and business-conduct risks.
- Oversee risk-based monitoring, auditing, data analysis, and control testing involving medical necessity, documentation, coding, charge capture, claims, denials, refunds, physician compensation and referral arrangements, conflicts of interest, exclusion screening, credentialing, licensure, and other identified risk areas.
- Provide compliance guidance for the MSO model and management services arrangements, supporting appropriate separation of administrative and clinical decision-making and consistent implementation of controls across affiliated professional entities.
- Direct the privacy program, including HIPAA and applicable state privacy requirements, privacy and security risk assessments, business associate oversight, incident and breach response, patient notification, mitigation, and coordination with Information Technology and Information Security.
- Maintain confidential reporting channels and lead the intake, triage, investigation, escalation, documentation, and resolution of reported or suspected compliance, privacy, fraud, waste, abuse, or ethical concerns; promote good-faith reporting and enforce non-retaliation protections.
- Ensure substantiated matters receive timely root-cause analysis, corrective and preventive action, disciplinary coordination when appropriate, repayment or disclosure assessment, sustainability monitoring, and documented closure.
- Develop, approve, and maintain the Code of Conduct and enterprise compliance and privacy policies, standards, procedures, and controls, with effective governance, version control, communication, and jurisdiction-specific implementation.
- Oversee role-based education for governing bodies, executives, clinicians, leaders, employees, and contractors, including onboarding and annual training; measure completion, comprehension, and program impact.
- Establish third-party compliance oversight, including risk-based due diligence, exclusion and sanction screening, business associate requirements, contractual compliance obligations, monitoring, and escalation for vendors and other business partners.
- Partner with internal General Counsel and other subject matter experts on regulatory interpretation, significant investigations, government disclosures, contracting, and remediation while preserving the independence of the compliance function.
- Serve as the primary compliance liaison to federal and state regulators, accreditation organizations, payors, and other external stakeholders; oversee responses to inquiries, audits, surveys, investigations, and site visits.
- Monitor laws, regulations, enforcement priorities, payor requirements, and industry standards affecting orthopedic practices, surgical facilities, and MSO operations, and translate changes into practical controls, policies, training, and operational guidance.
- Develop dashboards and key compliance indicators covering risks, hotline activity, investigations, audit findings, training, exclusions, corrective actions, and recurring trends; use results to demonstrate effectiveness and drive continuous improvement.