Director, Compliance Investigations

Thank you for considering a career at Ensemble!

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

At Ensemble Health Partners, we are redefining the healthcare revenue cycle through innovation, operational excellence, and an unwavering commitment to compliance and integrity.

The Compliance Director, Investigations will provide Compliance Program leadership for assigned service lines and/or locations, with primary accountability for the oversight of Compliance investigations — ensuring that reported concerns and suspected violations of the Compliance Program are evaluated, investigated, and resolved. This leader also serves as a trusted partner to client compliance partners, operational and executive leadership, promoting a culture of integrity, accountability, and continuous improvement while mitigating organizational risk.

Essential Job Functions

Compliance Investigations Oversight

Leads Investigations team and personally manages investigations including the following:

• Evaluate and manage compliance concerns and reports of suspected misconduct and perform and oversee investigations to ensure that all suspected violations of the Compliance Program are fully investigated and resolved.

• Oversee the intake, triage, prioritization, and assignment of reported compliance matters, ensuring timely and consistent handling in accordance with Compliance Program requirements.

• Coordinate the implementation of corrective action plans, monitoring progress and completion, and escalating as required — including overseeing complex overpayment/refund activities, claim correction efforts, and the resolution of systemic issues.

• Develop and perform training associated with investigations, government and payer coding audits, and settlements.

• Take, research as needed, and respond to day-to-day compliance questions, including providing effective guidance related to Compliance Program requirements and regulatory risk mitigation.

• Maintain awareness of fraud, waste, and abuse laws and regulations and current industry changes that may impact healthcare revenue cycle services domestically and internationally through personal initiative, continuing education, and peer-to-peer networking.

• Prepare and provide reports of investigation activities, findings, and outcomes as requested by Compliance Leadership.

Compliance Liaison Responsibilities

This role also serves as a Compliance Liaison to assigned Ensemble clients and/or service lines:

• Serve as the Compliance Liaison to assigned Ensemble clients and/or service lines, as assigned by leadership.

• Act as the primary compliance point of contact for assigned clients and/or service lines, building trusted relationships with client compliance officers and operational leaders.

• Facilitate timely, two-way communication of compliance matters, regulatory updates, and Compliance Program expectations between Ensemble Compliance and assigned clients and/or service lines.

• Attend and support recurring client and service line compliance meetings and align compliance activity with client-specific policies and requirements.

• Identify, triage, and escalate compliance concerns arising within assigned clients and/or service lines, and support resolution and follow-up.

• Support client-facing audit, monitoring, and reporting activities, and coordinate distribution of compliance communications (e.g., the monthly Regulatory Compliance Digest) to assigned stakeholders.

Qualifications

Required

• Healthcare compliance certification (CHC, CHPC, CHRC, CCEP, or equivalent).

• Bachelor's degree in Healthcare Administration, Business Administration, Law, Finance, or a related field.

• 8+ years of progressive healthcare compliance, regulatory, audit, risk management, or revenue cycle leadership experience.

• 5+ years of leadership experience managing teams and compliance programs.

• Strong knowledge of healthcare regulatory requirements, including False Claims Act, CMS, OIG guidance, and healthcare compliance frameworks.

• Demonstrated experience conducting investigations, audits, and risk assessments.

• Excellent communication, presentation, and executive stakeholder management skills.

• Demonstrated advanced usage of AI and the management of teams using AI to lean in to process and technological improvements, to include the exploration, experimentation, and application of AI.

• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Preferred

• Master's degree in Healthcare Administration, Business Administration, Public Health, Law, or related field.

• Experience supporting large, multi-site healthcare systems or revenue cycle organizations.

• Experience presenting compliance findings and recommendations to executive leadership and boards.

• Demonstrated working knowledge of Revenue Cycle services and processes.

This position pays between: $129,000- $193,500

Join an award-winning company

Five-time winner of “Best in KLAS” 2020-2022, 2024-2025

Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023

Energage Top Workplaces USA 2022-2024

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits –  We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. 
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.  
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. 
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company. 

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws.  Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered.  Individuals may reapply when located within the United States.

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.

This posting addresses state specific requirements to provide pay transparency.  Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position.  A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

Employment Disclaimers – Ensemble