Compliance Director

Position Summary
The Director of Compliance is responsible for providing strategic leadership and oversight to the Compliance Department. The Director will be responsible for advancing the compliance program through deep understanding of processes, controls and risk assessment findings and leverage technology and automation to ensure appropriate investigative and preventive controls are in place.

Accountabilities & Responsibilities
• Administer the company’s corporate compliance and accreditation program: including assessing, developing, and implementing auditing, monitoring, training and risk assessment activities
• Lead, develop and build structure within the Compliance team
• Develop a highly effective team through hiring, development, coaching and performance management
• Provide advice, education and guidance to employees on matters related to compliance, accreditation and ethical standards
• Guide and support monitoring, investigations and audits, corrective action plans, risk assessments and required reporting
• Develop annual and quarterly compliance risk assessments and compliance reviews
• Develop and promote compliance-related education, training and communication to ensure consistency for employees and appropriate contractors
• Partner with functional areas of the company such as Sales, Marketing, Patient Services, IT, Finance, Regulatory and Quality, Clinical to ensure activities, policies and processes are consistent with compliance and legal requirements.
• Develop, implement, and review company policies and procedures within the scope of existing state/federal Medicaid/Medicare requirements
• Assess, improve and streamline existing compliance programs
• Develop compliance analysis, reporting and visual dashboard
• Foster open communication from all levels of internal and external audiences
• Manage the Company’s accreditation status, state licensure, compliance with accreditation standards and renewal activities
• Interface with legal counsel and federal, state, and local agencies, as needed to address regulatory or compliance issues, concerns or questions
• Assist the business with responses to customer compliance-specific questions and concerns
• Meet regularly with department leadership to review their compliance metrics and identify opportunities and barriers
• Other duties as assigned

Education & Experience
Required:
• Bachelor’s degree or the equivalent combination of education, training, and work experience
• 5+ years of management experience in healthcare compliance,

Preferred:
• Juris Doctor or other graduate degree
• Healthcare Compliance Certification (CHC/(Certified in Healthcare Compliance), CHPC/(Certified in Healthcare Privacy Compliance) or CCEP (Certified Compliance and Ethics Professional).

Knowledge & Skills
• Extensive knowledge and understanding of the following in order to develop and lead an effective Compliance Program
o False Claims Act
o Anti-Kickback statute
o HIPAA
o Sunshine Act/Open Payments Reporting (and separate state statutes)
o AdvaMed Code of Ethics
o Food, Drug and Cosmetic Act
o Office of Inspector General
o Department of Health and Human Services
o HME licensing
o Payer coverage, coding and payment understanding
• Strong understanding of compliance concepts in the healthcare industry (especially fraud and abuse, confidentiality/protected health information, electronic security, anti-kickback, physician/clinician “sunshine” reporting)
• Ability to build collaborative relationships to drive consensus
• Demonstrated ability to develop and lead a team
• Communicates ideas both verbally and in written form in a clear, concise, and professional manner
• Strong communication skills with consultative skills and the ability to influence effectively
• Strong analytical skills
• Demonstrated ability to plan and complete work within tight time limitations
• Ability to apply creative problem-solving techniques and tools to compliance issues
• Ability to follow and conduct a compliance monitoring program
• Ability to provide information to a variety of audiences and deal effectively with confidential issues that are sensitive in nature
• Well versed in Microsoft Office tools including Word, Excel, PowerPoint or other relevant software
• Strong ownership and leadership mindset, able to adapt and thrive in ambiguous or uncertain environments
• Ability to adapt to changing environments and effectively manage change by providing hands on enthusiastic leadership
• Proven coaching skills that will impact both entry-level employees and develop leaders
• Ability to use data and analysis to drive decision making
• Ability to manage a department, providing assessment, training, feedback and guidance
• Demonstrated ability to proactively identify issues and problem solve as well as identify efficiencies
• Ability to thrive in a fast-paced and dynamic environment

Competencies
• Leadership
• Change Agent
• Integrity and Trust
• Decision Making
• Influence
• Collaboration
• Critical Thinking
• Conflict Management
• Communication
• Prioritization
• Service Orientation
• Foster Continuous Improvement