Assistant Vice President: Compliance - Maryland United States - 37624



JOB DESCRIPTION

Job #: 37624
Title: Assistant Vice President: Compliance
Job Location: , Maryland - United States
Employment Type:
Salary: $140,000.00 - $165,000.00 - US Dollars - Yearly
Other Compensation: Bonus
Employer Will Recruit From: Nationwide
Relocation Paid?: Yes

WHY IS THIS A GREAT OPPORTUNITY?


 Assistant Vice President of Compliance: This position implements and oversees the compliance programs for all diversified businesses and post-acute entities with three direct reports. This position assists the Chief Compliance Officer by ensuring quality and consistent compliance guidance along with advice to the diversified businesses and post-acute entities. This role will allow you to collaborate closely and provide support to colleagues in the Office of Corporate Business Integrity, including the designated Privacy Director and the OCBI Operations group, to ensure consistent and effective implementation of compliance and privacy operations and policies.

JOB DESCRIPTION

Implements and oversees organization’s compliance program for all diversified businesses, including: organization’s Medical Group; organization’s Family Choice; organization’s Home Health Care; organization’s Physical Therapy Network and organization’s National Rehabilitation Hospital (the post-acute entities); organization’s Corporate and Shared Services including Retail and Specialty Pharmacy; and organization’s Ambulatory Services, including organization’s Urgent Care, Ambulatory Surgical Centers, organization’s Ambulatory Care Centers, RadAmerica, organization’s Radiology Network and organization’s HouseCall Program.

Ensures entities have compliance programs that fulfill the requirements of the seven elements of the Federal Sentencing Guidelines and are aligned with the organization’s corporate compliance and privacy program; ensures compliance/privacy policies and procedures are implemented at the diversified businesses and post-acute entities in a manner that is consistent with corporate compliance and privacy policies and procedures; ensures that the annual corporate compliance and privacy work plan that has been approved by the Audit and Compliance Committee of the Board is executed properly and fully at the diversified businesses and post- acute entities; ensures quality, consistent compliance guidance and advice and training is provided to the diversified businesses and post-acute entities; collaborates closely and provides support to colleagues in the Office of Corporate Business Integrity (OCBI),including the designated Privacy Director and the OCBI Operations group, to ensure consistent and effective implementation of compliance and privacy operations and policies (e.g., annual conflict of interest disclosure process, Recovery Audit Contractor claim review processes, monthly healthcare exclusions screenings, Business Associate Agreement updates, etc.); and, oversees the coordination of any internal and external governmental compliance investigations or reimbursement reviews (MACs, ZPICs, etc.) with the diversified businesses and post-acute entities (and the Legal Department as necessary) to ensure these investigations/reviews are conducted appropriately and/or that responses to external entities are appropriate and consistent across the system.

Leads and manages the team of professionals to ensure comprehensive compliance and support to organization’s diversified businesses and post-acute entities.

Primary Duties and Responsibilities


Collaborates and communicates closely with management and team member counterparts in the OCBI to provide appropriate operational support to corporate compliance/privacy colleagues and to ensure consistent and effective implementation of compliance plan, operations and policies (e.g., annual conflict of interest disclosure process, Recovery Audit Contractor claims review process, monthly healthcare exclusions screenings, updated Business Associate Agreements, etc.).

Contributes to the achievement of established OCBI goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.

Develops and contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Ensures compliance with hospital/facility policies and procedures and governmental/accreditation regulations.

Develops and/or coordinates internal and external governmental compliance with the Legal Department and diversified businesses and post-acute entities as appropriate to ensure these investigations are conducted appropriately and/or that responses to external entities are appropriate and consistently executed across the system.

Ensures compliance with available enterprise-wide compliance data analytics for the diversified businesses and post-acute entities compliance and privacy program improvement and decision support purposes, including compliance data and information.

Ensures that the annual corporate compliance work plan that has been approved by the Audit and Compliance Committee of the Board is executed properly and fully at the diversified businesses and post- acute entities.

Implements and oversees organization’s compliance programs for all diversified businesses and post-acute entities. Ensures diversified businesses and post-acute entities have compliance programs that fulfill the requirements of the seven elements of the Federal Sentencing Guidelines and are aligned with the organization’s corporate compliance and privacy program.

Leads and manages the team of diversified business and post-acute entity professionals to ensure comprehensive and appropriate compliance guidance and support to organization’s diversified and post-acute entities. Ensures the guidance and advice provided is responsive, consistently executed across the enterprise, and promotes the execution of a high quality organizational compliance program. Oversees the development of compliant billing policies, processes and audit work plan specific to diversified businesses and post-acute entities.

Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.

Participates in the annual corporate compliance and privacy and Enterprise Risk Management (ERM) risk assessment process and work planning process.

Performs other duties as assigned.

Serves as a subject matter expert and provides analysis of key activities, processes and policy/procedures to develop and maintain compliance controls at the diversified businesses and post-acute entities. Facilities the delivery of quality, consistent compliance training and education for the diversified businesses and post-acute entities.

Working with the OCBI Operations group, oversees the coordination of any internal and external governmental compliance/privacy reviews (MACs, ZPICs, etc.) with the diversified businesses and post-acute entities (and the Legal Department as appropriate) to ensure these reviews are conducted properly and consistently across the system and/or that responses provided to external entities are appropriate and consistently executed across the system.

Works closely with the organization’s business development and Legal Department to provide necessary compliance/due diligence guidance for service line expansions.

 

QUALIFICATIONS

EDUCATION: Bachelor's Degree in related field.

EXPERIENCE: 7 years of progressively responsible experience in a project management role in compliance, operations, risk management, internal audit or a legal department in a healthcare setting. Working knowledge of healthcare laws, regulations, guidance and hospital and professional billing methodologies. Leadership and management experience required.

LICENSE/CERT/REG: Project Management Professional certification preferred. Certified in Healthcare Compliance or the ability to obtain within one year of start date.

SKILLS: Strong writing proficiency and oral communication skills. Strong analytical and problem-solving skills. Proficiency in working with Microsoft Office products, and other health care related applications. Exceptional ability to manage multiple projects and deadlines.

Education:
University - Bachelor's Degree/3-4 Year Degree

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