Job Description

GENERAL RESPONSIBILITIES:

The Director of Risk Management and Corporate Compliance (DRMCC) oversees the organization’s Risk Management and Corporate Compliance programs, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the organization. The position ensures the Board of Directors, management and employees are in compliance with the rules and regulations of regulatory agencies, that company policies and procedures are being followed, and that behavior in the organization meets the company’s Standards of Conduct. Additionally the position leads and coordinates the organization’s efforts to minimize risk and any potential liability that may threaten the success of the organization. This position is the organizations Compliance Officer, Privacy Officer and HIPAA Officer.

SPECIFIC RESPONSIBILITIES:

Administration

• Remains current on the healthcare market and working closely with other management team members, is able to provide proactive analysis of organizational areas that may have a positive or negative impact on Health Center’s operations.
• Responsible to stay current on best practices regarding Health Center regulatory and accreditation compliance, current and future healthcare delivery trends.
• Implements and sustains an education process that ensures a common knowledge base for providers and staff on Regulatory mandates, Risk Management, HIPAA, Corporate Compliance and other relevant areas throughout the organization.

Risk Management

• Ultimate responsibility for development and execution and the annual Risk Management Plan.
• Oversees organization wide Risk Management program, to include electronic database and incident reporting.
• Provides a planned organization wide process for reporting and managing claims and lawsuits in compliance with the Federal Tort Claims Act (FTCA). Completes the required annual Redeeming application for FTCA coverage.
• Serves as the lead WYH representative to the FTCA and commercial market professional liability insurers that provide coverage to WYH.
• Reviews current policies and procedures and propose changes to the Executive Leadership Team as appropriate.
• Responsible for receiving, reviewing, trending and analyzing incident reports and taking appropriate action.
• Present substance of incidents to the Governance and Compliance Committee, Environment of Care, Infection Control Committee, Pharmacy and Therapeutic Committee and external regulatory agencies as appropriate.
• Responsible to conduct root cause analysis as appropriate.
• Assist the CMO in peer review activities.
• Ensures corrective actions are implemented by appropriate managers and appropriate reports are provided to regulatory agencies as necessary.
• Leads the patient complaint process for follow up and investigations and works within the senior management team to make improvements.

Corporate Compliance

• Ultimate responsibility for developing the annual Compliance Plan for WYH and its approval by the WYH Board of Directors
• Assists the Center in ensuring compliance with all State and Federal regulations, to include routine OMIG, OIG and SAMS exclusion monitoring and annual certifications of a compliance program
• Participates in network-wide preparation for regulatory surveys, including HRSA, DOH,
• OASAS, OMH and others, in order to insure successful reviews.
• Works closely with the CEO to ensure departments are complying with various rules and regulations ensuring equal disciplinary treatment.
• Ensures knowledge of corporate compliance programs, policies and legal opinions are current and uses knowledge to implement changes to existing program, as appropriate.
• Develops corporate compliance policies and procedures as necessary/requested.
• Collects and investigates all potential corporate compliance submissions from programs, and enforces the non-intimidation/non-retaliation policy.
• Prepares and reports compliance issues to the CEO, Board of Directors, and Board Committees and to the regulatory authorities as required
• Conducts/designates corporate compliance audits.
• Creates, leads and executes training for boundaries in healthcare and ethics expectations of all staff.

Miscellaneous

• Works with Chief Talent Officer (CTO) on provider credentialing and privileging.
• Provides consultation on vendor contracts and other agreements as needed.
• Demonstrates excellence in both internal and external customer service.
• Understands and is able to effectively communicate HIPAA compliance, corporate compliance and client confidentiality.
• Ensures and/or remains in compliance with local, state, and federal regulation, i.e. DHHS HRSA NYS OASAS, OMH and NYSDOH.
• Adheres to the National Patient Safety Goals as defined by the Joint Commission and Whitney M. Young Jr. Health Center.
• Develops and manages compliance and risk management content for WYH’s Learning Management System (LMS) to keep staff educated and competent in these areas.
• Completes other duties as assigned.

Requirements

MINIMUM QUALIFICATIONS:

Bachelor’s Degree in Health or Human Services, minimum of 10 years’ experience in a healthcare setting to include leadership experience. Demonstrated knowledge of operational, financial, quality improvement, risk management and human resource procedures and regulations. At least 5 years of supervisory experience.

PREFERRED QUALIFICATIONS:

Master’s Degree in a healthcare/management discipline, certification in healthcare compliance (CHC).

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.

Salary Range: $100,000 - $115,000 annually