Director, Compliance Officer','!*!As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
The Compliance Director contributes to Conifer Health’s (Conifer) purpose by providing both strategic and day-to-day leadership to the compliance program designed to ensure Conifer fully complies with its Standards of Conduct and all applicable laws and regulations. The Compliance Director supports his/her respective area(s) of Conifer’s Ethics and Compliance program which may include: Compliance Operations and Programs; Compliance and Privacy – Client Engagement; or Coding Compliance. The Compliance Director will lead and support compliance program initiatives and provide leadership for a variety of projects.
Develops, implements, and oversees the compliance program; including (1) maintaining and expanding visibility of the compliance program at all levels within the organization (2) ensuring there is an effective compliance program and oversight in place to remain compliant with all local, state, and federal healthcare rules, regulations and adimistrative requirements and (3) leading and developing team members to support programmatic efforts.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
1)Compliance Operations and/or Programs
Facilitates and contributes to the development of the Annual Compliance Work Plan and related documents.
Develops and and leads ongoing compliance work plan reviews for purposes of identifying, assessing, and documenting potential compliance violations of the Standards of Conduct and policies and applicable local, state, and federal healthcare rules, regulations and administrative requirements; implements corrective action plans as required.
Reduces organization risk by identifying compliance risks and by developing and managing key work plan activities to address identified risks.
Creates and oversees a program to educate and communicate the importance of a strong culture of compliance to all Conifer leaders and team members – including the development and delivery of role-specific compliance training.
In collaboration with compliance and operational leadership, develops and/or oversees compliance policies and procedures.
Develops and implements key compliance monitoring activities; identifying, reporting, and implementing monitoring controls and making recommendations for training and/or other mechanisms to mitigate risks, or improve the efficiency or effectiveness of business operations and compliance program.
Partners and collaborates with leadership and business partners to communicate and integrate the compliance program throughout the organization.
Provides ongoing compliance-related support to team members and key decision makers
Compliance and Client Engagement
Leads and develops incident management team.
Continuously reviews and refines incident intake, investigation and mitigation processes.
Identifies and implements strategies geared toward improving overall compliance client engagement.
Provides ongoing compliance-related support to team members and key decision makers
Develops and maintains compliance policies and procedures related to the incident management process.
Leverages technology to improve upon incident management processes.
Partners with key Client Delivery leaders to communicate to our clients regarding compliance incidents and remediation plans
Partners with Compliance Systems and Operations to provide reporting on compliance incident trends across Conifer’s book of business
Presents specific client engagement topics to the Compliance and Audit Committee
2) Leads and/or participates in organizational projects related to the design, implementation, revision or maintenance of process and systems that promote compliance.
3) Serves as an internal expert and advisor in compliance matters
4) Collaborates with key leadership, team members, contractors and other stakeholders throughout Conifer to promote a culture of compliance.
If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Direct Reports:Compliance Officer, Manager, Specialist, Analyst, Sr. Specialist, and/or Sr. Analyst as applicable
','!*!KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to work independently with little supervision and seek guidance as needed to clarify assignments or request for information.
Excellent communication, customer service and time-management skills
Strong team-building and development skills
Possess basic business skills, an understanding of general compliance operations and department goals in the healthcare environment.
Proficient with various desktop applications such as Microsoft Excel, Word, PowerPoint and/or Access.
Intermediate knowledge of relational database management systems
Must be a team player - Always willing to help in whatever way possible and go the extra mile to get the job done.
Intuitive and skilled at problem solving in anticipation of team member and client request
Have the ability to make logical correlations between data points to determine if analysis is accurate
Detail oriented, meticulous and accurate in completing tasks on time.
Revenue Cycle Compliance Director Specifics:
Monitors, analyzes, interprets, and communicates regulatory changes related to coding, billing, and collections. Leads and oversees efforts to respond to new or changing regulations, including but not limited to communicating regulations to leadership and affected departments, assembling and chairing work teams.
Supports the process for investigating and addressing internal/external complaints regarding regulatory requirements.
Ensures compliance with existing rules, new rules, regulations and revisions, as set forth by the Center for Medicare and Medicaid Services (CMS), as well as other federal and state laws and regulations that govern matters related to hospital and physician revenue cycle.
Oversees the follow-up to ensure timely repayment is made for all identified overpayments received from government agencies and patients.
Oversees the development and implementation of compliance policies and procedures related to the organization’s hospital and physician revenue cycle.
Reduces organization risk by identifying risks related to hospital and physician revenue cycle and manage annual work plan to address identified risks.
Contribute to the annual compliance monitoring plan and oversee the components related to hospital and physican revenue cycle activities.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
Masters Degree in Business, Information Systems, Health Care Administration; Juris Doctorate or related field or equivalent years of related Manager experience required.
Include minimum certification required to perform the job.
Certified Healthcare Compliance (CHC) is preferred
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to work in sitting position, use computer and answer telephone
Ability to Travel
Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Office Work Environment-Position is located in Frisco, Texas
Up to 10% ','Managers and Directors','TX-Frisco','','','Full-time','Full-time','Days','Days','','','','','','','1805030934','Director, Compliance Officer