Healthcare Compliance Officer

Corporate Compliance Officer

Overview: The Compliance Officer oversees the organization's Compliance and Business Ethics Program.

Summary:

The Corporate Compliance Officer (CCO) is appointed by the Board of Managers to act as the 'quarterback' of compliance activities in the organization. Key functions are coordination and communication with regard to planning, implementing, and monitoring all documents and other information relevant to compliance activities, including, but not limited to, medical and billing records, and documents concerning the organization's marketing efforts and its arrangements with other healthcare providers, including physicians and independent contractors.

The CCO shall (1) receive periodic training in compliance procedures; (2) have direct access to the Board of Managers; and (3) be evaluated based upon proper execution of compliance responsibilities and promotion of adherence to the compliance program in the compliance manual.

While the CCO must rely on the expertise of key professionals in the organization in order to carry out the functions of the position, she/he must retain integrity and objectivity in order to avoid the appearance of deference to one or more discipline or department, thereby compromising the integrity of the program.

Duties and Responsibilities

Overseeing development and monitoring implementation of the Compliance Program (Program). Managing the life cycle of Program related policies and procedures.

Organizing and chairing the Leadership Compliance Committee.

Assisting the Board of Managers and the Leadership Compliance Committee in establishing methods to reduce the organization's vulnerability to fraud, abuse, waste, and compliance infractions.

Reporting on a regular basis to the Board of Managers' Quality & Compliance Committee on the progress of the Program's status, any material compliance events, and other business integrity matters as requested.

As needed, periodically updating the Program considering changes in the organization's needs; laws and regulations; and third-party payors health plans.

Developing, coordinating, and participating in a multifaceted educational and training program that is current and relevant to Team Members' roles and job functions which includes:

Maintenance of, along with the Human Resources Director, a Code of Conduct that provides current guidance to relevant Team Members about the company's expectations regarding compliance and ethical business practices;

Training regarding compliance with Federal program participation requirements as applicable to the individual's specific job duties;

Training regarding appropriate and sufficient documentation;

Prohibitions on paying or receiving remuneration to induce referrals;

Patients' rights;

Information regarding the duty to report suspected violations or questionable conduct and the mechanism for such reporting;

Training of vendors, suppliers and other contractors;

Maintenance and retention of training records.

Ensuring that all employees and managers understand pertinent Federal and State standards.

Ensuring that independent contractors and agents who furnish physician, nursing, or other health care services to the patients of the facilities are aware of patients' rights as well as the requirements of the organization's compliance program.

Developing and maintaining open lines of communication with employees to serve as an effective contact point for reporting problems and for clarifications of policy.

Development and implementation of policies and procedures for confidentiality and non-retaliation regarding reports for suspected violations or questionable conduct.

Coordinating personnel issues with Human Resources staff to ensure that the OIG's List of Excluded Individuals/Entities has been checked with respect to all employees and independent contractors.

Enforcing standards through well-publicized disciplinary guidelines.

Assisting financial managers in coordinating internal compliance review and monitoring activities, including periodic reviews of departments.

Assisting Department Heads in developing monitoring activities to monitor compliance in their departments on an ongoing basis.

Conducting or, as appropriate, overseeing internal investigations involving potential or actual noncompliance with legal requirements or company policies, procedures, or expectations of compliant and ethical workplace behavior and reporting the findings and recommendations to management in a manner consistent with applicable legal privileges and protections. Exercising the independent authority and responsibility to assign specific compliance issues to individuals outside the organization for review, as appropriate, such as legal counsel, accountants, and quality consultants. Designing and coordinating any corrective action resulting from compliance-related investigations.

Developing a budget for compliance related activities.

Maintaining a log of internal compliance investigations that documents the identification, investigation, and resolution of such matters; this contains (but is not limited to):

Documentation of the alleged violation;

A description of the investigative process;

Copies of interview notes and key documents;

A log of the witnesses interviewed and the documents reviewed;

The results of the investigation;

Any corrective action implemented.

Engaging outside legal counsel or subject matter experts as needed to assist with internal compliance investigations. Participating with the organization's counsel in the appropriate reporting of self-discovered violations of program requirements and interacting with legal counsel, government agencies, and other external parties on matters relating to compliance.

Continuing the momentum of the compliance program after the initial years of implementation.

Performing other functions as assigned.

Knowledge, Skills, and Abilities:

• A personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of the organization.
• Demonstrated knowledge of government and private payer reimbursement rules and policies, as well as fraud and abuse laws.
• Strong interpersonal and communication skills.
• Clear, concise, and persuasive writing and presentation skills.
• Unwavering personal and organizational ethical standards.
• Strong orientation to deadline and detail.
• Decisive and capable of exercising good judgment under pressure.
• Ability to manage a diverse and demanding workload.
• Word processing PC skills, knowledge of PowerPoint and Excel.
• Experience in health care compliance that is sufficient to carry out the duties and responsibilities set forth above.

EOE STATEMENT

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.