Compliance Director

>> We offer our team the best <<

• Medical, Dental and Vision Benefits
• Continued Education
• PTO Plan
• Retirement Planning
• Life Insurance
• Employee discounts

Position Summary: This position assists the EVP, Chief Compliance & Quality Officer in developing and overseeing the company’s compliance, privacy, and document retention programs to comply with healthcare program, state, and federal requirements and regulations. This position also manages a team of employees responsible for conducting privacy and compliance related investigations and responding to medical record requests and related subpoenas.

Essential Duties:

• Assists in overseeing the company’s compliance, privacy, and document retention programs
• Creates, monitors, and tracks completion of training programs
• Ensures relevant groups meet and maintain compliance requirements by preparing new policies and procedures, reviewing and updating existing policies and procedures
• Educating staff at all levels on compliance requirements
• Conducts internal audits and risk assessments and assists with the annual compliance work plan
• Researches and summarizes new and/or existing rules, regulations and contractual requirements and documents applicable controls and potential gaps
• Conducts investigations involving violations of law, corporate policies, and the Code of Conduct
• Develops compliance databases, tracking tools and auditing tools as needed
• Functions as liaison within the organization and with external organizations, including governmental and regulatory agencies
• Supports activities of the Compliance Committee
• Coordinates and responds to medical record requests and subpoenas
• Investigates compliance reports (including false claims, kickbacks, etc.) and oversees the investigation to completion including supervising any voluntary refund, if applicable
• Manages a team of employees tasked with investigating compliance and privacy issues and responding to medical record requests and subpoenas. Managing includes daily activites and administrative functions, including scheduling of PTO requests, team and individual performances, coaching, training, reviewing and assigning work and other typical management duties
• Oversees the company’s third-party ethics hotline
• Provides direction and guidance to department staff, intervenes as necessary to resolve issues
• Travel occasionally to conduct in-person trainings, attend conferences, or otherwise as needed
• Always maintains a high degree of confidentiality due to access to sensitive information
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department

• Follows all Medicare, Medicaid, and HIPAA regulations and requirements
• Abides by all regulations, policies, procedures and standards
• Performs other duties as assigned

Performance Responsibilities:

• Maintains positive internal and external customer service relationships

• Maintains open lines of communication
• Plans and organizes work effectively and ensures its completion
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in Continuous Quality Improvement
• Represents the organization professionally at all times

Position Requirements & Competencies:

• Bachelor’s degree in Health Care, Health Care Administration, Public Health, Public Administration, Public Policy, JD, or other related field or a combination of relevant work experience
• 4+ years of experience in health care compliance or related field, in a provider or payer setting preferred
• Knowledge and experience in healthcare privacy laws, preferred
• Ability to travel occasionally to conduct in-person trainings, attend conferences, or other reasons, as necessary Working knowledge of compliance-related issues such as Fraud, Waste, and Abuse and Anti-Kickback regulations, preferred
• Principles of effective analysis and highly effective writing
• Ability to prioritize, work independently and meet deadlines
• Ability to coordinate and be team leader on large products spanning multiple departments
• Excellent verbal and written communications skills
• Excellent management skills
• Ability to effectively analyze, interpret, apply and communicate policies, procedures and regulations
• Ability to operate PC-based software programs including proficiency in Word, Excel, and PowerPoint

To apply via text, text 6461 to 334-518-4376.

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