Job Description

Directs, plans, designs, implements, and maintains a system-wide compliance audit program and policies and procedures that provide the basis for ensuring adequate internal controls and compliance with all laws and regulatory requirements. Oversees and promotes system-wide coding compliance to applicable laws, regulations, and coding guidelines. Ensures compliance to developing government and regulatory agency standards.

Job Responsibility

• Leads a Compliance group by communicating with and developing staff members, and building consensus for programs and goals that support a business, function or geographic area.
• Develops and articulates a short-term strategic vision for areas of responsibility.
• Oversees coordination, performance, education, and reporting related to compliance internal audits. Performs annual compliance risk assessments to generate annual compliance plans and repairs annual audit timeline.
• Develops compliance auditing and monitoring policies and procedures; prepares the audit status summary reports for presentation to the committee.
• Collaborates with management and other appropriate personnel involved with release of protected health information to ensure coordination and cooperation under the health system's administrative policies and procedures and legal requirements.
• Assists in investigating reports of billing non-compliance.
• Oversees and promotes the system-wide compliance coding standards.
• Monitors and audits established regulations, policies and procedures, including communication processes, self-assessments, and coding practices to ensure compliance standards.
• Provides support to coding staff and all personnel involved in coding and billing at each facility regarding coding compliance activities.
• Oversees the development and implementation of education and training programs to support coding compliance based on an assessment of the results of compliance audits and self-assessments.
• Collaborates with Internal audit, coding compliance, and research compliance to minimize overlap in compliance activities.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Preferred:

1. Chairs meetings and coordinates monthly Facility Compliance Committee for their respective sites.
2. Provides advice and acts as a resource to Facility management for compliance issues.
3. Advises the Facility’s employees, contractors and vendors as appropriate, agents and any applicable governing Board members on issues of regulatory compliance.
4. Assists in the coordination of the investigation of suspected violations received through the Alert Line and other channels.
5. Oversees, follows-up and implements correction actions to investigations and other issues generated by the compliance program.
6. Provides liaison between facility specific compliance efforts and System-wide compliance efforts.
7. Participates in the periodic compliance self-assessments, as needed.
8. Participates in developing and implementing internal controls capable of preventing and detecting significant instances or patterns of illegal, unethical, or improper conduct.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.
• 8-12 years of relevant experience and 7+ years of leadership / management experience, required.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).