We are representing a large regional healthcare system in their search for a Director Compliance & Privacy.
Why Join Us:
- Position reporting directly into the SVP Chief Compliance Officer
- Included in Fortune Magazine’s ‘100 Best Companies to Work For’ in 2021 and the previous six years
- Well-established organization with over 20,000 employees across a diverse and stable business network
- Business with a technology-forward approach to growth and a strong patient-first approach to healthcare delivery
Responsibilities:
- Reporting to the SVP Chief Compliance Officer, managing a team of six
- Oversee, lead and administer the Compliance and Privacy Programs in alignment with Group policies
- Report on a regular basis to the Chief Compliance Officer and business unit Board on program effectiveness including progress and efforts to reduce vulnerability to fraud, waste and abuse
- Continually improve compliance and privacy programs in light of organization needs and consistent with laws and regulations that impact business operations
- Develop and oversee annual compliance/privacy work plan
- Implement written policies, procedures and standards of conduct
- Establish and chair Compliance and Privacy Committees for business unit
- Develop, coordinate and oversee annual internal compliance review and monitoring work plan including processes and controls to provide compliance with legal requirements and standards
- Coordinate external audits such as recovery audit contractors for governmental agencies and/or commercial payer audits
- Analyze data, implement benchmarking and publish dashboards for key compliance and privacy risk areas.
- Develop and coordinate multifaceted educational and training programs for employees that focus on the elements of the compliance and HIPAA privacy programs and seek to ensure that employees and management are knowledgeable of and comply with federal and state laws and regulations including Medicare/Medicaid program requirements
- Ensure pro-active provider education is provided in response to identified risk areas such as coding, billing, documentation and HIPAA privacy / information security requirements.
- Develop effective lines of communication and awareness within the Compliance and Privacy Programs.
- Facilitate internal reporting processes including the Compliance Hotline and open lines of communication for reporting of questions or concerns by employees, contractors, patients or others
- Serve as an internal consultant to management team and key operations personnel regarding compliance and privacy questions
- Serve as the key contact in responding to government investigations or queries such as Office of Civil Rights (Privacy), Office of Inspector General or other governmental agencies; respond promptly to detected offenses, develop corrective action and report finding to Board and Management. Make reports to governmental agencies when appropriate via established channels
- Develop and coordinate coding programs and coding strategy and provide oversight of the coding audit team.
- Provide and/or implement physician documentation and coding education plans
- Develop and manage annual compliance department budgets
Qualifications:
- Essential Education: Bachelor’s Degree; Desirable Education: JD
- Desirable Certification: CHC or CPCO
- A minimum of five years healthcare compliance and privacy experience, including people-management, compliance with federal and state regulations related to coding, documentation, billing practices, Medicare/Medicaid
Application Process for Director Compliance & Privacy: Qualified professionals are to submit resume to Steve Harrison: steve@conselium.com
Published by Conselium Executive Search, the global leader in compliance search.
