Head of Compliance (Part-Time)

Mira Mace is a venture-backed telehealth and care management company helping Medicare patients navigate the healthcare system through people-centred navigation and technology. The company operates as a professional corporation and management services organisation (PC-MSO), delivering care by phone and video across multiple states, billed to Medicare, Medicare Advantage, Medicaid, and commercial payers.

This senior, hands-on role owns the company's full regulatory and operational compliance posture as it scales. The Head of Compliance will set policies, conduct audits, train staff, monitor regulatory developments, and work alongside engineers and legal counsel to embed compliance into both operations and software. The role spans PC-MSO structuring, HIPAA privacy and security, coding and billing integrity, revenue cycle review, fraud and abuse controls, and a formal compliance programme aligned to OIG General Compliance Program Guidance.

• Maintain PC-MSO arrangement compliance, covering management services agreements, corporate practice of medicine rules by state, fair-market-value fees, and the boundary between clinical and business decisions.
• Own the HIPAA privacy and security programme, including policies, risk assessments, BAAs, workforce training, access reviews, and breach response.
• Audit Medicare coding and billing (care management, E&M, and related services) against documentation and time requirements prior to claim submission.
• Review revenue cycle management practices end to end, covering eligibility, claim submission, denials and appeals, patient cost-sharing, waivers, and overpayment refunds.
• Monitor regulatory developments including the Physician Fee Schedule, NCCI edits, MAC guidance, the OIG Work Plan, and Medicaid and commercial payer policy updates.
• Build and run a formal compliance programme per OIG guidance, incorporating policies, training, monitoring, audits, a hotline, and regular leadership reporting.

• Seven or more years in healthcare compliance with Medicare Part B billing and coding as a core focus.
• Hands-on experience with a PC-MSO or comparable physician-practice management structure.
• Deep working knowledge of HIPAA, the Anti-Kickback Statute, Stark Law, and the False Claims Act.
• Experience across revenue cycle operations including claims, denials, appeals, patient cost-sharing, and overpayment management.
• Preferred: CHC, CHPC, CPC, or CPCO certification, or a JD with healthcare counsel experience.
• Preferred: experience with care management services (CCM, PCM, APCM, BHI), remote monitoring, telehealth, or Medicare Advantage and Medicaid managed care across multiple states.

Mira Mace is a venture-backed startup pairing people-centred care navigation with technology to help Medicare patients understand their care, stay connected to providers, and access the resources they need. The team includes veterans from Google, Meta, Amazon, Landmark Health, and Parsley Health.