The Director (of) Compliance and Integrity has responsibility for managing the effective implementation of Hendrick Health’s Ethics and Compliance Program (“Program”) elements associated with compliance-related investigations. This includes adherence to the requirements and guidance set forth (as applicable) by various regulatory authorities, including but not limited to, the Office for Civil Rights (OCR), Office of Inspector General (OIG), the United States Department of Justice (DOJ) and the Centers for Medicare and Medicaid Services (CMS). The Director provides instruction and oversight to a team of investigators responsible for activities of the investigations process, including the triage, management and timely resolution of case investigations. The Director oversees the Compliance Integrity Line (i.e., 'Hotline') activity and prepares periodic internal reports for the Audit and Compliance Committee of the Hendrick Health Board of Trustees and presentation to various Compliance Committees and key internal stakeholders. The Director of Compliance and Integrity works with the VP & General Counsel to serve as a consultant, investigator, educator, coordinator, and liaison across various departments and functions. The Director of Compliance and Integrity interacts with system executives and leaders, physicians and clinicians, and caregivers throughout the organization and provides leadership and oversight within the Compliance Department.
The Director of Compliance and Integrity supervises compliance department staff and trains employees on regulatory, audit, billing, coding documentation, and other general compliance matters, to ensure that the health system receives appropriate reimbursement and conforms to applicable guidelines and regulations. The Director of Compliance and Integrity serves as a resource for compliance staff by providing support and assisting in promotion of professional development, refining methodologies, and improving departmental work products. The Director assures the accuracy and timeliness of the auditing and review process and the Annual Compliance Work Plan.
5+ years' experience in compliance, audit, legal or equivalent field.
Masters degree in healthcare, business or related field and/or CHC (Certified in Healthcare Compliance) designation is required. Will consider highly qualified candidate with 10 years of healthcare compliance program work experience and management experience in lieu of required education.
Healthcare Compliance Certification from the Compliance Certification Board (“CCB”) and/or a Graduate Certificate in Health Care Compliance within two (2) months of appointment and maintain such certification throughout employment.
Additional Compliance-related certifications are preferred (e.g., CPC (Certified Professional Coder), CHRC (Certified in Healthcare Research Compliance), RHIA (Registered Health Information Administrator), CPMA (Certified Professional Medical Auditor), or CCS (Certified Coding Specialist).
Clinical, coding, auditing or related work experience is required. Knowledge of and/or experience in regulations that impact hospitals, hospital charging, documentation, coding, and billing procedures, medical records, and knowledge of audit techniques required. Requires excellent verbal and written communication skills. Ability to problem solve and perform research is essential. Must be organized, versatile, and able to work independently.
Responsible for programs, policies, and practices that ensure the system is in compliance with Joint Commission, HIPAA, federal, state, and local regulatory requirements. Plans, organizes, coordinates, develops and maintains the system’s Compliance Program to ensure the system is in compliance with applicable federal, state and local regulatory requirements including HIPAA
Internal Number: 17775
About Hendrick Health
If you are ready to be part of a carefully selected team, dedicated to exceptional care, Picture Yourself at Hendrick! Hendrick Health is a not-for-profit organization located in Abilene, Texas. Since 1924, Hendrick Health has provided quality healthcare services to 24 surrounding counties. For over a decade, Hendrick has been annually recognized as a Gallup Exceptional Workplace recipient. Our Mission – To deliver high quality healthcare emphasizing excellence and compassion consistent with the healing ministry of Jesus Christ.