Corporate Compliance Officer Overview: The compliance officer provides direction and oversight of the compliance program. Summary: The compliance officer is responsible for identifying and assessing areas of compliance risk for the organization; communicating the importance of the compliance program to the executive management and the board of directors. Key functions are coordination and communication with regard to planning, implementing, and monitoring all documents and other information relevant to compliance activities, including, but not limited to, medical and billing records, and documents concerning the organization's marketing efforts and its arrangements with other healthcare providers, including physicians and independent contractors. Duties and Responsibilities Overseeing development and monitoring implementation of the Compliance Program (Program). Managing the life cycle of Program related policies and procedures. Organizing and chairing the Leadership Compliance Committee. Assisting in establishing methods to reduce the organization's vulnerability to fraud, abuse, waste, and compliance infractions. Reporting on a regular basis on the progress of the Program's status, any material compliance events, and other business integrity matters as requested. As needed, periodically updating the Program considering changes in the organization's needs; laws and regulations; and third-party payors health plans. Developing, coordinating, and participating in a multifaceted educational and training program that is current and relevant to Team Members' roles and job functions which includes: Maintenance of, along with the Human Resources Director, a Code of Conduct that provides current guidance to relevant Team Members about the company's expectations regarding compliance and ethical business practices; Training regarding compliance with Federal program participation requirements as applicable to the individual's specific job duties; Training regarding appropriate and sufficient documentation; Prohibitions on paying or receiving remuneration to induce referrals; Patients' rights; Information regarding the duty to report suspected violations or questionable conduct and the mechanism for such reporting; Training of vendors, suppliers and other contractors; Maintenance and retention of training records. Ensuring that all employees and managers understand pertinent Federal and State standards. Ensuring that independent contractors and agents who furnish physician, nursing, or other health care services to the patients of the facilities are aware of patients' rights as well as the requirements of the organization's compliance program. Developing and maintaining open lines of communication with employees to serve as an effective contact point for reporting problems and for clarifications of policy. Development and implementation of policies and procedures for confidentiality and non-retaliation regarding reports for suspected violations or questionable conduct. Coordinating personnel issues with Human Resources staff to ensure that the OIG's List of Excluded Individuals/Entities has been checked with respect to all employees and independent contractors. Enforcing standards through well-publicized disciplinary guidelines. Assisting financial managers in coordinating internal compliance review and monitoring activities, including periodic reviews of departments. Assisting organzational leaders in developing monitoring activities to monitor compliance in their departments on an ongoing basis. Conducting or, as appropriate, overseeing internal investigations involving potential or actual noncompliance with legal requirements or company policies, procedures, or expectations of compliant and ethical workplace behavior and reporting the findings and recommendations to management in a manner consistent with applicable legal privileges and protections. Exercising the independent authority and responsibility to assign specific compliance issues to individuals outside the organization for review, as appropriate, such as legal counsel, accountants, and quality consultants. Designing and coordinating any corrective action resulting from compliance-related investigations. Developing a budget for compliance related activities. Maintaining a log of internal compliance investigations that documents the identification, investigation, and resolution of such matters; this contains (but is not limited to): Documentation of the alleged violation; A description of the investigative process; Copies of interview notes and key documents; A log of the witnesses interviewed and the documents reviewed; The results of the investigation; Any corrective action implemented. Engaging outside legal counsel or subject matter experts as needed to assist with internal compliance investigations. Participating with the organization's counsel in the appropriate reporting of self-discovered violations of program requirements and interacting with legal counsel, government agencies, and other external parties on matters relating to compliance. Continuing the momentum of the compliance program after the initial years of implementation. Performing other functions as assigned. Qualifications and Education Requirement Bachelor degree in Business Administration or Health Administration. Masters degree in Hospital Administration, Business Administration or a related field is preferred Certified in Healthcare compliance Minimum of five years experience in compliance within the healthcare industry, to include leadership experience Knowledge, Skills, and Abilities: A personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of the organization. Demonstrated knowledge of government and private payer reimbursement rules and policies, as well as fraud and abuse laws. Strong interpersonal and communication skills. Clear, concise, and persuasive writing and presentation skills. Unwavering personal and organizational ethical standards. Strong orientation to deadline and detail. Decisive and capable of exercising good judgment under pressure. Ability to manage a diverse and demanding workload. Word processing PC skills, knowledge of PowerPoint and Excel.
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