Job Posting Position Title:
Compliance & Risk Management DirectorGeneral Summary:
The Compliance & Risk Management Director is responsible for key responsibilities to ensure the adherence of the organization policies and procedures, especially regulatory and ethical standards. Perform regular audits, design control systems and help to design and implement company policies.
Conducts and direct the internal investigation of compliance issues in partnership with Human Resources. Assess product, compliance, and operational risks and develop risk management strategies. Provide a better assessment of the risk management policies and protocols to come up with policies and recommendations to avoid threats, reduce or transfer risks and/or mitigate the effects of those which are essentially unavoidable.Summary of Essential Duties: Compliance
- Ensures corporate policies are accurate, current and in compliance with local, federal, and state regulations.
Reviews and updates policies as laws change
- Interprets and disseminates information on regulatory matters
- Develops and updates compliance issues in manuals, as needed. Develops/modifies company forms and contracts used in business operations.
- Conducts research, compiles data, and prepare papers for consideration and presentation to the CEO and Board of Directors
- Responsible for training the Line staff, Board of Directors & Senior Management on Compliance matters
- Oversees and monitors the implementation of the compliance program
- Develops, coordinates, and participates in a multifaceted educational and training program that focuses on the elements of the compliance program, and seeks to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent federal and state standards
- Responsible for ensuring that SCFHC complies with all regulatory agency requirements, including the Health
Insurance Portability and Accountability Act (HIPAA), and accreditation standards by implementing and administering practices, programs, and policies.
- In cooperation with other departments responds to government investigations and queries regarding compliance matters.
- Responsible for carrying out complex healthcare audits, such as the establishment of objectives, goals, quality measures, and timelines for the team’s activities in a timely manner.
- Independently investigates and acts on compliance matters including the coordination internal investigations
(e.g., responding to reports of problems, 'hot-line' calls, or suspected violations) and any resulting corrective actions with all SCFHC departments, providers and sub-providers, agents and, if appropriate, independent contractors.
- Will carry out risk analysis on healthcare compliance, discover areas of potential compliance risk and vulnerability, and create and implement solutions to eliminate the potential risks.
- Responsible for administering and maintaining various compliance technology solutions, including monthly newsletter, Hotline, Risk Assessment software, Audit/Monitoring, and Compliance Committee documentation.
- He/she is also in charge of managing compliance team staff and organizing and maintaining compliance regulatory files.
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- Collaborate with Human Resources department to ensure the implementation of consistent disciplinary action strategies in cases of compliance standard violations.
- Develops policies and programs that encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.
- Educates all staff on compliance principals and best practices
- Oversees all organization licensing and contracts.
- Manages the Board of Directors Compliance Committee and provides all compliance reports for Compliance
Committee and Board review
- Be informed of current legislation and enforcement issues affecting the healthcare industry, as well as compliance best practices,
Job Specifications: (Knowledge, skills, abilities and experience normally required for competent performance)
- Coordinates the organization safety and risk management activities
- Conducts risk assessment, which involves analyzing risks as well as identifying, describing and estimate the risks affecting the organization
- Prepares risk reporting in an appropriate way for different audiences, for example, to the Executive Committee or the Board of Directors, so they understand the most significant risks, to business heads to ensure they are aware of risks relevant to their parts of the business and to individuals to understand their accountability for individual risks
- 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
- Conducts audits of policy and compliance to standards, including liaison with internal and external auditors
- Provides support, education and training to staff to build risk awareness within the organization.
- Assists in performing all tasks necessary to achieve the organization's mission.
Education and Knowledge
- MBA, JD or other advanced degree, CHC,
- Knowledge of Healthcare Compliance, and Healthcare Administration
- Required: Seven (7) years or more of successful executive experience working for an FQHC
- Required: Experience in conducting internal investigations to include conducting interviews, drafting statements, gathering documentation/evidence, identifying the proper model of proof and evidence standard, drafting investigative reports, and case management
- Required: Experience drafting policies/procedures, working with analytics, drafting reports/training presentations, reviewing/editing documents such as contracts, MOUs, and other agreements
Skills and Abilities
- Superb analytical, research, writing, advocacy and problem-solving skills
- Ability to inspire trust, communicate effectively, and build relationships across all SCFHC constituencies
- A desire to work as part of a senior management team and possessing the emotional intelligence to make the team work stronger together when compared to the sum of all individual member’s work
- An understanding of, and interest in, the legal and regulatory challenges facing FQHC, 330s and community clinics
- A sophisticated ability to understand and manage health care risk and compliance issues
- A solid working knowledge of a broad range of subject matters related to employment law (Title VII, disability law, other anti-discrimination laws), and healthcare compliance matters (Fraud, Waste & Abuse, False Claims
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Act, Civil Monetary Penalties, Stark laws, Anti-Kickback Statute, Safe Harbors, HI-TECH, HIPAA, OSHA, PPACA), as well as, Healthcare Compliance Plans
Licensure and Certifications
- Exceptional interpersonal, written, and oral communication skills
TO APPLY, PLEASE VISIT:
- AAPC Certification or Certified Healthcare Compliance (CHC) certification (certification may be obtained within 1 year of employment).
Job Type: Full-time
Pay: $95,000.00 - $130,000.00 per year
- AD&D insurance
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Retirement plan
- Vision insurance
- Compliance management: 5 years (Required)
Work Location: One location