Director, Compliance Audit & Risk - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 156964
The Director, Compliance Audit & Risk is responsible for overseeing all ongoing activities related to the development, implementation, and maintenance of Community's Audit Program. Oversee and manage efforts for the internal audit program that ensures the soundness of internal controls over key financial and operational processes, including IT General Controls. Responsible for oversight of the internal audit department staff and monitoring the Model Audit Rule (MAR) Compliance Program. Responsible for operational, compliance and claims audits to ensure Community's operations and processes are compliant with laws and regulations.
Must maintain open lines of communication with internal partners, regulators, vendors and other internal or external partners to assure collaborative working relationships. Provides direct support to the Chief Compliance Officer, focusing on the ongoing monitoring of control processes across all product areas and functions within the organization. Development of policies and procedures and corrective action plans to ensure that Community?s Internal Audit, Risk Management and operational and compliance audit programs function efficiently and effectively. Develop and maintain a professional team approach with both external and internal partners to achieve accurate results and the organizations strategic goals.
BA/BS degree (Masters preferred); CIA or CPA
Five years previous experience in Risk Management and/or Auditor role. Preferred experience in managed care organizations.
Two years management experience in a healthcare preferably managed care organizations.
Ability to maintain an attitude of independence and objectivity towards all internal and external partners.
Ability to organize tasks and work independently.
Knowledge of statistics and sampling methodology.
Knowledge of billing (professional and facility) and coding (CPT, ICD-10, HCPCS, DRG)
Strong attention to details and deadlines. Strong communication skills.
Writing /Composing: Correspondence /Reports
Please be advised: Effective Wednesday, September 1st, 2021, with the exception of those who receive an approved exemption, all new hires must provide proof of vaccination against COVID-19 or receive the first dose of a COVID-19 vaccine by the second Friday of employment.
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.