Healthcare Compliance Officer

Healthcare compliance officers work collaboratively with physicians and other healthcare professionals to ensure that medical records are accurate and maintained. They also confirm that healthcare operations and compliance laws are followed, verifying the “compliant reimbursement” of patient services. In addition, healthcare compliance officers perform internal reviews, audits, and analyses of areas within their facility to determine best practices. There is some relation to the field of quality assurance or verification-and-validation within the field of healthcare compliance.

Professionals in this role usually hold a bachelor’s degree in healthcare compliance, business administration, finance, economics, human resources, and other related fields. What matters most in gaining an entry-level position is the ability to demonstrate competency in the areas of analytics, composition, logic, regulations, calculation, document management, risk assessment, risk management, professional mediation, and even counseling. More targeted and discipline-specific courses include subjects such as ethical issues in healthcare, human physiology, basic pharmacology, health law and regulation, and much more.

The demand for certified healthcare compliance officers has increased as the components of our healthcare system have become more complex. There is an ever-growing need for the specialized, certified skillset of a healthcare compliance officer. Especially in the era of big data and social analytics, compliance officers have come to the forefront of the healthcare industry. 

Read on to learn more about education, certification, and salary in the field, in addition to specializations and examples of healthcare compliance degree programs.

Healthcare compliance is a set of checks and balances used in conjunction with many other aspects of healthcare. Where you find healthcare information systems and medical operations staff, you can find healthcare compliance officers. Jobs that utilize the application of compliance expertise include:

• Compliance analyst
• Ethics and compliance officer
• Healthcare or hospital compliance officer
• Healthcare or hospital compliance specialist
• Healthcare or hospital regulatory affairs specialist
• Health privacy officer
• HIPAA compliance specialist
• Integrity officer
• Internal auditor
• Medicare compliance analyst
• Medicare compliance specialist
• Privacy analyst
• Regulatory compliance specialist

Admissions requirements for healthcare compliance-related bachelor’s degrees include a background in the health sciences, healthcare administration, human health, wellness, or psychology. 

Aspiring students should note that as long as mathematics and science prerequisites were met in high school (or demonstrated via placement tests), they can be prepared for study in this field. University bachelor’s programs in healthcare compliance typically require 120 credits of undergraduate work in healthcare management or a related major.

Students pursuing study in healthcare compliance should pay close attention to a school’s accreditation status. Schools with either programmatic or regional accreditation have a proven track record of excellence, having met a set of peer-reviewed standards in their curriculum. 

The Compliance Certification Board (CCB) offers programmatic accreditation to university compliance and ethics programs at the certificate, master’s, and doctoral levels. Other reputable regional accreditation entities are listed on the Council for Higher Education Accreditation (CHEA) website.

Cleveland State University – Cleveland-Marshall College of Law 

Both JD and non-JD students can complete a healthcare compliance certificate at Cleveland State University’s Cleveland-Marshall College of Law. This 18-credit program provides aspiring professionals in this field with the necessary legal knowledge they need to work in an ever-changing healthcare industry. While this program is excellent for professionals already working in law, it can also be an excellent fit for healthcare professionals such as nurses, doctors, and administrators. 

In addition to classes in health law and compliance, students will also take HIPAA and privacy, fraud prevention, and finance courses. While JD and non-JD students will take classes together, non-JD students will not be graded on the same curve. This is to accommodate students who don’t have a law background and may have other demands such as work or family life.  

• Location: Cleveland, OH
• Duration: One year
• Accreditation: American Bar Association (ABA)
• Tuition: $1,159.30 per credit 

American University – Washington College of Law 

Law students at the American University Washington College of Law can complete a healthcare compliance certificate as part of their studies. This certificate is open to JD, LLM, and MLS students. Students who complete this certificate and meet the CCB criteria are eligible to sit for one of five CCB certification exams. 

Both JD and LLM students are required to complete a compliance-related writing project in their Advanced Topics in Health Law and Food and Drug Law Writing Seminar as well as complete an externship in healthcare compliance. There is no additional application required to complete this program, as any student can enroll in the required courses. However, students must submit for certification approval prior to graduation. 

• Location: Washington, DC 
• Duration: Three years
• Accreditation: Compliance Certification Board (CCB), American Bar Association (ABA)
• Tuition: $2,099 per credit 

DePaul University – College of Law

At DePaul University’s College of Law, students can complete a healthcare compliance certificate alongside their law education. This program is open to enrolled J.D., M.J., and LL.M. students who want to pursue a career in healthcare compliance. Through completing this certificate, students gain an in-depth understanding of healthcare regulation and policies, standards of care, fraud, and abuse. 

There are two required courses all students must complete in health policy and law and healthcare compliance regulation. Students then must choose three more elective courses in topics such as food and drug law, bioethics, risk management, and patient safety. Upon graduating from law school and completing all required coursework, graduates can apply to the Associate Dean For Academic Operations for a letter of certification. They may also sit for CCB certification exams. 

• Location: Chicago, IL
• Duration: Three years
• Accreditation: Compliance Certification Board (CCB), American Bar Association (ABA) 
• Tuition: $1,688 per credit

Arizona State University 

ASU’s bachelor’s program in healthcare compliance prepares aspiring compliance officials with the knowledge they need to excel in the field. ASU was the first institution to offer a four-year degree in healthcare compliance. This program is ideal for anyone interested in the regulatory, ethical, or business compliance sides of the healthcare industry. 

The cutting-edge curriculum is offered both on-campus and online and provides a foundation in subjects such as accreditation standards, auditing, auditing policies, billing procedures, coding procedures, and federal compliance regulations.

• Location: Phoenix, Arizona
• Duration: Four years
• Accreditation: Higher Learning Commission (HLC)
• Tuition: $12,984 per year 

Drexel University – Kline School of Law 

Drexel University offers this completely online program of certification in healthcare compliance for students who have already attained a bachelor’s degree in a related field. Drexel recommends that candidates interested in the program take courses in healthcare compliance and healthcare administration. The Kline School of Law oversees the professors who lecture in the program, an indication of its quality and caliber.

• Location: Philadelphia, Pennsylvania
• Duration: Varies, six months to one year
• Accreditation: Compliance Certification Board (CCB)
• Tuition: $915 per credit

University of Southern California – Gould School of Law 

USC Gould offers this completely online healthcare compliance certificate program for students who want to round out their HCC officer skills. 

Expect courses in health policy, regulations in the healthcare industry, business in healthcare, finance in healthcare, patient privacy, and HIPAA compliance best practices. The program focuses on building an understanding of broad areas of the industry, such as healthcare law and healthcare regulatory standards.

• Location: Los Angeles, California 
• Duration: One Year
• Accreditation: Western Association of Schools & Colleges (WASC)
• Tuition: $76,438 per year

George Washington University – College of Professional Studies

The Health Care Compliance Certificate for Working Professionals is a specialized program offered by the renowned Mitchell Hamline School of Law in St. Paul, Minnesota. This program is meticulously designed to cater to the needs of individuals keen on honing their skills and knowledge in healthcare compliance. This includes seasoned healthcare professionals, attorneys looking to specialize, or individuals seeking a career shift. The program’s comprehensive curriculum can be completed in 11 months, offering 11 credits.

The program holds accreditation from the Compliance Certification Board and equips its graduates with Mitchell Hamline’s proprietary CHC Exam Toolkit. With competitive tuition costs and financial aid options, this program is accessible to many students. The program’s format offers flexibility with fully online courses, enabling students to learn from world-class faculty and industry experts at their convenience. Upon graduation, students become part of a lifelong alumni network and receive continuous career support. The program is tailored to prepare participants to adeptly maneuver through the intricate maze of healthcare laws and regulations, fostering an ethical corporate culture.

• Location: St. Paul, MN
• Duration: 1 1 months
• Accreditation: Compliance Certification Board (CCB)
• Tuition: $836 per credit 

Stetson University – College of Law

The online master’s of jurisprudence in healthcare compliance at Stetson University’s  College of Law is a two-year intensive program designed for professionals who do not have a legal background. The emphasis of this program is on regulatory compliance law as it pertains to healthcare practices, clinical research, and healthcare administration. 

Admission requirements include a personal statement, a completed application, a letter of recommendation, and GRE or GMAT test scores or a waiver request based on work experience. 

• Location: Gulfport, FL
• Duration: Two years
• Accreditation:  American Bar Association (ABA)
• Tuition: $33,680 per year

St. Mary’s University – School of Law

Students who do not wish to practice law but want a legal education can complete the master’s of jurisprudence at St. Mary’s University School of Law. This program has several concentrations, including a CCB-accredited healthcare compliance law concentration. This concentration is ideal for professionals already working in the healthcare sector. 

Since this program is offered online, students can complete their studies at their own pace and without having to relocate. To graduate from this program, students must earn 30 total semester-hours. 

• Location: San Antonio, TX
• Duration: One to two years
• Accreditation: Compliance Certification Board (CCB)
• Tuition: $1,428 per credit 

University of Pittsburgh – School of Law

The University of Pittsburgh School of Law offers a ten-month accelerated healthcare compliance online graduate certificate. Designed for working professionals, this program can be completed without ever having to visit campus. Most courses and seminars can be completed in just eight weeks each. 

This program provides an overview of regulations, laws, and legal issues in relation to healthcare and compliance. Since this program is CCB accredited, graduates are eligible to sit for one of the CCB certification exams. 

• Location: Pittsburg, PA
• Duration: 10 months
• Accreditation:  Compliance Certification Board (CCB)
• Tuition: $11,500 for the entire program

Northwestern University

The Regulatory Compliance Interdisciplinary Studies Certificate Program is a specialized offering from the esteemed Northwestern School of Professional Studies. This program is designed to provide students with a deep understanding of the regulatory environment across multiple industries. The curriculum covers a broad spectrum of subjects, including clinical research, healthcare compliance, and quality systems, aiming to foster a cross-pollination of best practices and systems in these areas.

The certificate program is primarily targeted towards students who hold a graduate degree and are interested in expanding their knowledge and skills in regulatory affairs and quality assurance. The faculty comprises industry experts who bring real-world insights into the classroom. The details regarding the program’s course schedule, tuition, registration information, and more can be found on the program’s webpage.

• Location: Chicago, IL
• Duration: Two years
• Accreditation: Higher Learning Commission (HLC) 
• Tuition: $4,189 per course 

Michigan State University 

Aspiring healthcare compliance officers who are looking to step into leadership roles can complete the online master’s of science in healthcare management compliance. This 28-month program covers topics such as analytics, cost analysis, strategic management, ethics, and supply chain. Students can choose a concentration in either enterprise risk management, healthcare compliance, healthcare regulations, or implementing compliance systems. A capstone project is required to graduate. 

To be considered for admission, applicants must be employed or have been employed in healthcare or have three years of work experience in any industry. Other requirements for admission include a bachelor’s degree, at least a 3.0 GPA, and a high potential for advancement into organizational leadership.   

• Location: East Lansing, MI
• Duration: 28 months
• Accreditation: Commission on the Accreditation of Healthcare Management Education (CAHME)
• Tuition: $1,000 per credit hour

Expect a minimum of two years of schooling, with up to seven years total, when considering a graduate degree and an area of specialization within healthcare compliance. 

Candidates generally need an additional six months to one year of study to become Certified in Healthcare Compliance (CHC), plus one to three years of clinical healthcare compliance experience, depending on the type of professional certification chosen. (These credentials are detailed at length in the sections below.) 

Certifications typically require applicants to have a requisite number of years of experience (which varies), in addition to any other educational requirements. 

Associations, organizations, and societies give professionals an opportunity to network with other people in the field, and tap into a rich body of knowledge. More information on that is below.

Becoming a healthcare compliance specialist, as mentioned above, should take students a minimum of about three years and up to as many as seven if aspiring healthcare compliance professionals take longer to gain clinical and industry experience in real-life settings.

Step 1: Graduate from High School (Four Years)

As a high school student, a focus on classes in the health sciences, psychology, biology, statistics, and economics will build a solid foundation for later study of healthcare compliance. Additional coursework in mathematics, statistics, science, and business will further strengthen this foundation.

Step 2: Earn an Associate or Bachelor’s Degree (Two to Four Years)

Earning an associate’s degree in healthcare compliance is generally all that is required to get a foot in the door in this industry, although a bachelor’s degree can put students in a position to qualify for further education and certifications.

Earning a BA or BS degree in psychology or healthcare compliance science is ideal for work in this industry, but degrees in mental health services and healthcare administration could also provide the necessary skills for success in the field.

Step 3: Gain Industry Experience (Two Years or More)

One way to advance your career as a healthcare compliance officer is to gain work experience in the healthcare industry itself. This can help a person prepare for certification and higher-level positions, which are typically required for candidates seeking positions in upper management or as clinical directors.

Step 4: Earn a Master’s or Professional Degree (Two Years or More, Optional)

Pursuing a master’s degree in healthcare compliance means, in most cases, entering into a law program. Because regulations, laws, and compliance ethics shift and change constantly, possessing current knowledge of the healthcare compliance law landscape is invaluable. And it could increase earning potential, as well as open the door to higher-level healthcare compliance opportunities in leadership. 

Step 5: Become a Certified Healthcare Compliance Official (Six Months or More)

The Compliance Certification Board (CCB) of the Health Care Compliance Association (HCCA) issues the three main certifications in healthcare compliance:

• Certified in Healthcare Compliance (CHC)
• Certified in Healthcare Research Compliance (CHRC)
• Certified in Healthcare Privacy Compliance (CHPC)

To qualify to sit for the CHC exam, for example, there are two routes: professional or educational. For the professional route, a candidate must have one year of full-time compliance work experience or 1,500 hours in the past two years. Qualifying work experience must meet the “Detailed Content Outline” detailed in the candidate handbook. For the educational route, a candidate must have completed a certificate program from a CCB-accredited university within the past two years.

For both pathways, candidates must have 20 hours of qualifying continuing education, including at least 10 from live training events, which have been completed within the past year.

Requirements for other credentials vary slightly.

Additionally, the HCCA provides the Certified in Healthcare Compliance Fellowship (CHC-F) and three corporate offerings: Certified Compliance & Ethics Professional (CCEP), Certified Compliance & Ethics Professional International (CCEP-I), and Certified Compliance & Ethics Professional Fellowship (CCEP-F).

A healthcare compliance officer is responsible for ensuring that official standards of healthcare recording, documentation, and law observation are upheld. They conduct investigations and audits to assess the degree of risk in a healthcare model, draft plans for improving compliance practice, and monitor to ensure the program is following best practices and standards. 

Certified healthcare compliance officers must be aware of federal and state regulations and ensure that healthcare entities maintain compliance with government agencies, acts, guidelines, and laws. The job is at times similar to that of human resources personnel, as internal outreach, training, reskilling, and upskilling initiatives may fall to individuals in healthcare compliance positions as well.

There are several organizations that offer certifications for healthcare compliance professionals.

The Health Care Compliance Association (HCCA) Compliance Certification Board (CCB) is one of the premier credentialing organizations in this field. Employers are now requiring CCB certification for compliance-related positions in a variety of fields, from industrial to commercial to medical. Completing a graduate degree in healthcare compliance usually means that the professional work experience requirement, usually three years in length, has been met. 

As mentioned above, the CCB offers two fellowships as well as professional certification in the following areas:

• Certified Healthcare Compliance (CHC)
• Certified Healthcare Research Compliance (CHRC)
• Certified Healthcare Privacy Compliance (CHPC)
• Certified Compliance and Ethics Professional (CCEP)
• Certified Compliance and Ethics Professional International (CCEP-I)

Another organization that certifies compliance skills is the American Academy of Professional Coders (AAPC), which offers the credential of Certified Professional Compliance Officer (CCPO).

The Bureau of Labor Statistics (BLS 2023) reports that the healthcare compliance-related field of medical and health services management is projected to add 139,600 new jobs nationally between 2022 and 2032—a 28 percent increase, which is a rate more than three times the projected average for all occupations during that decade. 

The BLS notes that the required entry-level education for a healthcare compliance officer is typically a bachelor’s degree, although more advanced degrees and credentialing can increase one’s earning power. 

Here is the detailed salary data for the 359,640 compliance officers employed in the US (BLS May 2022): 

• Average annual salary: $76,980
• 10th percentile salary: $41,050
• 25th percentile salary: $52,490
• 50th percentile (median): $71,690
• 75th percentile salary: $97,050
• 90th percentile: $118,060

Here are some alternatives to a career as a healthcare compliance officer.

Become a Clinical Research Coordinator

Clinical research coordinators are responsible for the management of day-to-day tasks in clinical trials. Typical duties include interviewing trial participants, monitoring data collection, adhering to regulatory and ethical guidelines, and preparing reports. They are employed by universities, government agencies, pharmaceutical companies, and private research labs. 

• Typical Education: Bachelor’s degree
• Licensing or Certifying Organization:  Society of Clinical Research Associates (SOCRA)

Become a Healthcare Project Manager

Healthcare project managers are responsible for the coordination of a healthcare operation. This can be an ongoing operation like a clinic or a temporary operation like a vaccine clinic or mobile hospital. They are also responsible for the direct supervision of staff involved with the operation. Primary tasks include identifying problems, strategizing solutions, delegating tasks, managing teams, and monitoring progress to stay on schedule. 

• Typical Education: Bachelor’s degree
• Licensing or Certifying Organization: Project Manager Institute (PMI)

Become a Healthcare Risk Manager

Healthcare facilities come with an inherent amount of risk. To mitigate and manage the risk, many large healthcare organizations hire healthcare risk managers. This manager’s role is to assess the current risks of the organization, identify places where there is unnecessary risk, audit how risks are handled, educate staff on how to manage risk, and develop plans to reduce risk. 

• Typical Education: Bachelor’s degree
• Licensing or Certifying Organization: American Hospital Association