Manage day-to-day compliance with Medicare and Medicaid program requirements, including federal CMS rules, state-specific Medicaid regulations, and value-based care contract obligations.
Monitor regulatory developments and translate their impact into clear, actionable guidance for product, clinical, and operations teams.
Lead responses to audits, compliance reviews, and requests from federal and state regulators, health plans, and contracting partners.
Maintain and continuously improve the compliance program framework, including policies, procedures, risk assessments, and training programs.
Privacy & Data Compliance (HIPAA and Beyond)
Lead for HIPAA Privacy and Security compliance, including BAA management, minimum necessary standards, and workforce training.
Partner with engineering and product teams to evaluate data practices, new product features, and vendor integrations for privacy and security risk.
Evolve the company’s privacy and data security with cross-functional teams.
Risk Identification & Business Enablement
Act as a trusted advisor to business, product, and clinical teams — flagging compliance risks early and helping design compliant solutions rather than blocking progress.
Build and maintain a compliance risk register; triage issues by severity and likelihood and prioritize remediation proportionate to actual risk.
Qualification
Ability to multitaskStrongly PreferredExperience at a digital health company
Required
3+ years of healthcare compliance experience with direct exposure to federal programs (Medicare, Medicaid, or both) and the regulatory frameworks governing them (CMS, OIG, HIPAA, FWA).
Demonstrated ability to operate in an ambiguous, fast-moving environment — startup or high-growth company experience strongly preferred.
Deep working knowledge of HIPAA Privacy and Security rules and their practical application to technology products and digital health services.
Experience building or materially improving compliance programs, not just operating within established ones.
Strong communication skills — able to explain complex regulatory requirements in plain language and make crisp risk/benefit recommendations to business leaders.
Ability to multitask, prioritize, and manage projects and tasks.
Experience supporting building processes, procedures, and workflows that enable sustainable business scaling.
Strong collaboration skills with thought partners from clinical, operations, finance, and leadership
Proven ability to prioritize competing demands and make risk-proportionate decisions.
Mission-driven and passionate about improving outcomes for underserved communities
Strongly Preferred
Experience at a digital health company, health plan, or managed care organization operating in Medicaid and/or Medicare programs.
