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Director Compliance Investigations

Location
Brentwood, TN, United States

Posted on
Dec 07, 2021

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Director, Compliance Investigations','7410-5383','**MEMBERS ONLY**SIGN UP NOW***. Support Center','!*!POSITION SUMMARY:

The Director, Compliance Investigations assists in the operation and management of the Company Compliance program and is responsible for assuring the quality of the internal investigation program to include an effective and consistent approach to reporting/intake, triage, investigation, corrective action recommendations and documentation of each step in the investigation process. The Director will investigate, and support investigations undertaken by members of Internal Investigations team, Business Integrity Partner team, the Compliance Monitoring and Regulatory Support team and market- or facility-level Ethics and Compliance Officers. The Senior Director will work closely with and support investigations by other functions, including Legal, Human Resources, Risk, Privacy and Security. The Director will align their efforts to prevent, detect, and correct non-compliance and will support an environment that encourages information sharing, collaboration, and process improvement to ensure effectiveness, efficiency, and service excellence across multiple teams.

ESSENTIAL FUNCTIONS: 


To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation. 
Responsible for continuously improving internal investigations protocol and coordinating with other functions that conduct investigations, including Human Resources, Legal, Risk, Privacy and Security.
Investigate, analyze, and apply judgment to complex fact patterns, including those requiring an understanding of federal health care program requirements, fraud and abuse laws, and enforcement policies.
Supervise, support and assure the quality, thoroughness and timely completion of investigations led by members of the Internal Investigations team, Business Integrity Partner team, the Compliance Monitoring and Regulatory Team, market- and facility-level Ethics and Compliance Officers.
Participate in and the lead the development of corrective action recommendations where compliance failures are identified.
Responsible for implementing a framework to ensure consistent corrective action recommendations across the enterprise.
Ensure all investigations, investigatory findings and recommendations for corrective action are appropriately documented.
Produce and analyze reports of investigations to identify and highlight trends or systematic concerns.
Participate in or otherwise support internal investigations conducted by other functional areas, including Human Resources, Legal, Risk, Privacy, and Security.
Regular and reliable attendance.
Perform other duties as assigned.


Additional Information:


Position services both internal co-workers and external customers, clients, patients, contractors, and vendors.
Access to and/or works with sensitive and/or confidential information. 
Exhibit a comprehensive understanding of healthcare regulatory and compliance (e.g., HIPAA).  Skilled in the application of policies and procedures.  Knowledge of Business Office Standards and Recommended Practices.


SUPERVISORY RESPONSIBILITIES:

Responsible for supervising investigation team employee(s).

Supervise the work of others, including planning, assigning and scheduling work, reviewing work and ensuring quality standards, training staff and overseeing productivity. May offer recommendations for hiring, termination and pay adjustments, but do not have final responsibility for making these decisions.
','!*!KNOWLEDGE, SKILLS & ABILITIES:

The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: Bachelor's Degree

Experience: 7 years of experience

Certifications: N/A preferred CHC, ACFE, AFHI

Licenses: N/A

Skills and Abilities: 

Business Mathematical Skills -- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rates, ratios, and percentages and to draw and interpret graphs.

Moderate Computer Skills -- Frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc. Ability to create, maintain and incorporate simple functions into documents, spreadsheets, databases, and presentations to support business objectives.

Complex Communication: Frequently communicates complex information and interacts with management. Can present, resolve and address delicate situations. Can motivate and persuade others.

Varied Business Problems: Problems are varied and complex, requiring analysis or interpretation of the situation. Problems are solved using knowledge and skills, general precedents and practices.

Department Specific Impact: Decisions impact the management and operations within a department. May contribute to business and operational decisions that affect the department.

Moderate Independent Judgement: Results are defined; sets personal own goals and determines how to achieve results with few or no guidelines to follow; supervisor/manager provides broad guidance and overall direction.

Project Management: Handle multiple complex projects simultaneously including task delegation, project oversight, and resource allocation.

Oversees and assures quality for a significant segment of a functional area within the department. 

PHYSICAL AND MENTAL DEMANDS:

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 job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell.  The employee must occasionally lift and/or move up to 20 pounds.  Repetitive motion of upper body required for extended use of computer. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT AND TRAVEL REQUIREMENTS:


Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.
Works in well-lit, ventilated and climate controlled office environment with routine office equipment; some equipment has moving mechanical parts.
In hospital environment, may be exposed to hazards and unusual elements, which may include but are not limited to bloodborne pathogens and / or contagious illnesses, toxic chemicals, and biohazardous materials which may require extensive safety precautions and the use of protective equipment.
Noise level in the work environment is typical for an office and/or hospital environment.
Moderate overnight travel (up to 30%) by land and/or air.

','Please select a valid job field','Tennessee-Brentwood','','Full-time','Day shift, 7-10 hr/shift, weekdays only','Day shift, 7-10 hr/shift, weekdays only','Director, Compliance Investigations

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