Clinical Compliance Specialist

The Clinical Compliance Specialist will provide guidance to the Compliance & Quality Assurance Department, a strategic initiative designed to close existing gaps in clinical operations and regulatory oversight across the ophthalmology practice and affiliated ambulatory surgery centers (ASC). This role ensures adherence to regulatory standards, drives continuous quality improvement, and supports operational excellence throughout the organization.

Essential Functions

Assist in the development, maintenance, and standardization of internal policies and SOPs across clinical and administrative functions.

Coordinate internal and external audits; identify compliance risks and implement corrective actions.

Oversee Medicare Access and CHIP Reauthorization (MACRA)/MIPS submissions and monitoring, collaborating closely with the RCM and clinical team.

Manage ASC Agency for Health Care Administration (AHCA) quarterly reporting requirements and ensure timely, accurate submissions.

Partner with physician leadership to align clinical operations with regulatory and quality expectations.

Ensure monthly clinical leadership visibility and standardized documentation of clinical SOPs.

Assist with physician recruitment and onboarding, including contract tracking, ad postings, and scheduling oversight (meetings, PTO, and clinical rotations).

Coordinate patient satisfaction initiatives (surveys, feedback analysis, mystery shoppers).

Liaise with MSOs, ODs, PCPs, and internal stakeholders for experience feedback and grievances.

Manage patient and payer grievances and ensuring appropriate legal and insurance-related follow-up.

Organize external coding audits and ensure findings are integrated into improvement plans.

Support operational teams in updating and aligning SOPs across departments.

Promote a consistent culture of service excellence by leading customer service and professionalism training initiatives.

Ensure all departments have structured training programs and that implementation is monitored.

Assist in designing and rolling out new training and compliance-related education efforts.

Provide operational structure by overseeing daily, weekly, and monthly performance reporting.

Collaborate with Finance and department leads to collect, analyze, and act on performance data.

Ensure key organizational metrics are consistently tracked and shared with leadership.

Job Specifications

Typically has the following skills or abilities:

Bachelor's degree in Healthcare Administration, Nursing, or related field or equivalent experience.

Minimum 4 years of experience in clinical operations, compliance, or practice management, preferably in an ophthalmology or ASC setting.

Demonstrated experience managing regulatory reporting (MIPS, AHCA, etc.).

Strong interpersonal and leadership skills with the ability to work cross-functionally.

Excellent communication, organization, and problem-solving skills.

Knowledge of CMS, HIPAA, AHCA, and other applicable regulations.

Experience with physician management, recruitment, and credentialing workflows.

Familiarity with EHR and practice management systems; data reporting and analytics proficiency.

Travel required between various clinic site locations up to 70%.

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VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability, or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here.