Head of Compliance – Part-Time

🔥 14 hours ago

🇺🇸 United States – Remote

⏱ Part Time

🔴 Lead

🚔 Compliance

👻 Ghost score 15%

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Mira Mace

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 2025

💼 Consulting

🛡️ Insurance

📦 Logistics

Consulting • Insurance • Logistics

Mira Mace is a patient advocacy and healthcare navigation service that connects Medicare beneficiaries and other patients with expert care advocates who manage insurance issues, pre-authorization appeals, appointment scheduling, care coordination, and medical-bill review. Advocates are reachable by text or call, create individualized care plans, and work to prevent delays, surprise bills, and gaps in care so patients can more easily access the right in-network providers and in-home support.

📋 Description

• Own Mira Mace's regulatory posture as it scales • Keep the PC-MSO arrangement compliant, including management services agreements, corporate practice of medicine rules, fair-market-value fees, and clinical/business decision boundaries • Own the HIPAA privacy and security program, including policies, risk assessments, vendor BAAs, workforce training, access reviews, and breach response • Audit Medicare coding for care management, E&M, and related services against documentation and time requirements • Review revenue cycle practices end to end, including eligibility, claim submission, denials and appeals, copay and coinsurance collection, cost-sharing waivers, and overpayment refunds • Track regulatory developments including the Physician Fee Schedule, NCCI edits, MAC guidance, OIG Work Plan and enforcement actions, and Medicaid and commercial payer policy • Advise on changes in plain language • Address fraud, waste, and abuse risks involving the Anti-Kickback Statute, Stark, False Claims Act, and beneficiary-inducement rules • Build and run a compliance program based on the OIG's General Compliance Program Guidance, including policies, training, monitoring, audits, a hotline, and leadership reporting • Set policies, review work, train the team, and respond to rule changes and payer inquiries • Work alongside engineers to embed compliance into software

🎯 Requirements

• 7+ years in healthcare compliance, with Medicare Part B billing and coding at the center of it • Hands-on experience with a PC-MSO or similar physician-practice management structure • Deep working knowledge of HIPAA, the Anti-Kickback Statute, Stark, and the False Claims Act • Experience with revenue cycle operations: claims, denials, appeals, patient cost-sharing, and overpayment refunds • Practical ability to give clear, actionable compliance guidance • Comfort working in a fast-moving startup • Ability to work alongside engineers to build compliance into software • Certification such as CHC, CHPC, CPC or CPCO preferred • Experience with care management (CCM, PCM, APCM, BHI), remote monitoring, or telehealth services preferred • Experience with Medicare Advantage and Medicaid managed care plans across multiple states preferred • JD, or experience working closely with healthcare counsel preferred

🏖️ Benefits

• Part-time (fractional) role with flexible hours