About Casa Esperanza

Casa Esperanza, Inc. is a bilingual/bicultural behavioral health treatment provider serving Boston and the Merrimack Valley. Our mission is to empower individuals and families to recover from addiction, trauma, mental illness, and other chronic medical conditions; overcome homelessness and discrimination; and achieve health and wellness through comprehensive, integrated care.

About the role

The Associate Director of Compliance & Quality Improvement is a key leadership role responsible for designing, implementing, and managing a comprehensive compliance program across the behavioral health system. Reporting directly to the Director of Clinical Operations & Network Strategy, this position ensures that all organizational activities, clinical operations, and business practices adhere to federal, state, and payer regulations, internal policies, and ethical standards.

The Associate Director will establish and lead the compliance infrastructure—developing systems, policies, and processes that minimize organizational risk, ensure readiness for audits, and drive quality improvement. The role will require close collaboration with departments including Payer Relations, Provider Relations, Practice Management, Quality, Human Resources, Clinical Operations, Finance, and others to ensure a culture of compliance and accountability across the enterprise.

What you'll do

• Compliance Program Leadership
• Design, implement, and oversee the organization’s Compliance Department and comprehensive compliance program, ensuring alignment with regulatory requirements, accreditation standards, and organizational goals.
• Develop, update, and enforce compliance policies and procedures covering clinical, operational, billing, privacy, and administrative activities.
• Establish mechanisms for reporting, investigating, and resolving compliance concerns, ensuring timely and appropriate corrective actions and performance improvement projects.
• Create and maintain a compliance governance structure, that includes regular reporting to the leadership teams in conjunction with the Director of Clinical/Medical Operations & Network Strategy & Development which provides compliance forecasting on a continuous basis
• Monitor regulatory developments in behavioral health and ensure timely communication and implementation of necessary changes.

Regulatory Oversight & Risk Management

• Oversee compliance with all applicable federal and state regulations, including HIPAA, CMS, Medicaid, Medicare, CARF, and other/payer-specific standards as needed
• Develop a risk assessment framework to identify, prioritize, and mitigate potential areas of compliance vulnerability.
• Conduct and manage internal audits and monitoring activities to ensure accuracy and integrity in billing, documentation, clinical operations, and administrative practices.
• Lead investigations into compliance violations, coordinate corrective actions, and ensure follow-up and documentation.
• Serve as the organizational liaison for external audits, payer reviews, and regulatory inspections.
• Prepare comprehensive compliance reports and risk analyses for executive leadership.

Program Management & Quality Initiatives

• Establish and manage a structured Compliance Program Management Office (PMO) for overseeing ongoing and ad hoc compliance and quality improvement initiatives.
• Plan, lead, and track organization-wide projects focused on audit readiness, quality improvement, and risk reduction.
• Collaborate with Clinical and Operations leadership to align quality and compliance initiatives with performance improvement goals.
• Implement data-driven compliance dashboards and tracking systems for real-time visibility into key compliance indicators.
• Partner with the Quality and Clinical Operations teams to ensure performance improvement activities support regulatory compliance and best practices.

Collaboration & Cross-Functional Engagement

• With the collaboration of the Director, Clinical/Medical Operations & Network Strategy & Development work in close partnership with:
• • Payer Relations to ensure adherence to payer contract requirements, credentialing standards, and utilization review expectations.
  • Provider Relations to reinforce provider education, training, and compliance with documentation, coding, and clinical protocols.
  • Practice Management to maintain compliant workflows, patient privacy standards, and operational efficiency.
  • Human Resources to manage compliance training programs, employee onboarding education, and disciplinary processes when appropriate.
  • Finance & Billing Teams to ensure claims integrity and compliance with reimbursement requirements.
• Serve as a trusted compliance advisor to operational leaders, ensuring integration of compliance considerations in all decision-making processes.

Training, Education & Culture

• Develop and implement a comprehensive compliance training and education program for staff and leadership at all levels.
• Promote a proactive culture of compliance, ethics, and transparency throughout the organization.
• Provide ongoing guidance and mentorship to department leaders to strengthen internal accountability and compliance ownership.

Qualifications

Education: Bachelor’s and/or Master’s degree in Healthcare Administration, or related field preferred but not required if equivalent experience standards are met

Required Experience:

• • Minimum 4 - 5 years of experience in healthcare compliance, preferably within behavioral health, mental health, or integrated care systems.
  • Demonstrated experience building and leading compliance programs or departments.
  • Strong background in payer compliance, audits, and risk mitigation.
  • Knowledge of federal and state healthcare regulations, including HIPAA, CMS, OIG, and behavioral health licensing standards.
• Certifications (Preferred):
• • Certified in Healthcare Compliance (CHC) or Certified Professional Compliance Officer (CPCO) or willingness to obtain certification within one year of employment
• Skills & Competencies:
• • Proven ability to manage complex compliance initiatives and cross-departmental collaboration.
  • Strong analytical, investigative, and project management skills.
  • Exceptional written and verbal communication skills for training, policy development, and leadership reporting.
  • Strategic thinker with the ability to operationalize compliance frameworks into scalable systems.

Reports To: Director of Clinical Operations & Network Strategy

Work Environment & Travel:

• Hybrid or on-site role depending on organizational needs.
• Moderate travel to clinics, regional offices, or audit sites as needed.

Schedule

• Full-Time, 40 hours per week, Monday-Friday, 9-5pm

What we offer:

Casa Esperanza Benefits Package:

• Holiday Pay (12 days per year + 1 floating holiday)
• Paid Time Off (PTO) - 18 days year one, 20.5 days at year 2, 23 days at year 5
• Sick Pay - 10 paid days per year
• Long/ShortTerm Disability 
• Paid by Company Life Insurance
• Health Insurance (Medical, Dental, Vision)
• Health Reimbursement Arrangement (HRA)
• FSA/DCA (Flexible Spending Account & Dependent Care)
• ComPsych Guidance Resources - EAP
• Educational Opportunities
• Tuition Remission
• Employee Ticket at Work (Discounts for Entertainment, travel, movies; etc.)
• Career Advancement Opportunities
• Increased Salary for Credentials
• and more....

Physical & Mental Requirements

While performing the duties of this job, the employee is regularly required to walk, stoop, kneel, crouch, or crawl and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include distance vision, peripheral vision, and depth perception.

At Casa Esperanza, Inc., the health and safety of our people is our number one priority. That’s why all offers of employment are contingent on the candidate showing proof of being fully vaccinated against COVID-19 (currently one dose of the Johnson & Johnson vaccine or two doses of the Pfizer or Moderna vaccine and boosted, when eligible) to pass the pre-employment requirements. Individuals with medical issues or religious beliefs that prevent them from getting the vaccine may request an exemption from the vaccine requirement.

Casa Esperanza’s EEO Statement

Casa Esperanza, Inc. values its diverse workplace and encourages women, people of color, LGBTQIA+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, older members of society, and others from minority groups and diverse backgrounds to apply.

We recruit, hire, employ, train, promote, and compensate individuals based on job-related qualifications and abilities. Casa Esperanza, Inc. also has a longstanding policy of providing a work environment that respects the dignity and worth of each individual and is free from all forms of employment discrimination, including harassment, because of race, color, sex, gender, age, religion or religious creed, national origin, ancestry, citizenship, marital status, sexual orientation, gender identity, gender expression, genetic information, physical or mental disability, military or veteran status, or any other characteristic protected by law.  All employees, interns, volunteers, and contractors of Casa Esperanza, Inc. are responsible for maintaining a work culture free from discrimination and harassment by treating others with kindness and respect.

Casa Esperanza, Inc. also provides reasonable accommodation to qualified individuals with disabilities or based on a sincerely held religious belief, in accordance with applicable laws. If you need to inquire about an accommodation or need assistance with completing the application process, please email hr@casaesperanza.org.