Compliance Director

Description

SUMMARY:

Salary Range: $135,000-$155,000

The Director of Compliance is accountable for a broad range of corporate compliance activities.  Directs the daily operations of Acuity’s Compliance Program, ensuring the development, implementation, and ongoing effectiveness of the OIG’s recommended seven elements of a compliance program. Participates in Compliance Committee meetings.

ESSENTIAL FUNCTIONS:

To perform this job successfully, an individual must be able to perform each essential function satisfactorily with or without accommodation.  The requirements listed below are representative, but not all inclusive, of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

• Oversees development and implementation of compliance policies and procedures, quality standards, effective training and compliance with such training.
• Oversees Compliance team and provides leadership, direction, training, and feedback to mentor and develop staff.
• Performs regular company-wide risk assessment and develops an audit work plan for compliance and operational audits to ensure proper control systems are in place for key and identified risk areas.
• Leads audit program.  Continually monitors and improves internal and external audit and monitoring processes to ensure organization is compliant with applicable laws and regulations.
• Provides direction, oversight and guidance on coding audits.
• Advises on relevant federal and state laws, HIPAA, CMS regulations, anti-kickback laws, the False Claims Act, and other healthcare fraud and abuse laws.
• Manages the planning, scheduling and implementation of changes required for meeting organizational Compliance Program effectiveness.
• Develops and implements training programs designed to promote awareness and understanding of Compliance Program and industry laws and regulations.
• Responds to potential and/or alleged violations of Code of Conduct, policies, procedures, and state or federal laws or regulations by conducting and/or guiding investigations when appropriate, ensuring the implementation of corrective actions.
• Provides quarterly and annual reporting as required and/or as requested.
• Oversees development and implementation of an annual Compliance Work Plan and monitors adherence to policies, procedures, regulations, contractual requirements.
• Develops, implements and maintains a privacy program that enable effective privacy practices which minimizes risk and ensures the confidentiality of protected health information (PHI), paper and/or electronic, across all media types.
• Works with department leaders, senior management, Chief Compliance Officer to establish governance on the Compliance Program.
• Collaborates with information security officer to ensure alignment between security and privacy compliance programs.
• Establishes an ongoing process to track, investigate and report inappropriate access and disclosure of protected health information.
• Ensures organization has and maintains appropriate privacy and confidentiality consents, authorization forms and information notices and materials reflecting current organization, industry standards, and legal practices and requirements.
• Establishes and administers a process for investigating and acting on privacy and security complaints.
• Maintains an appropriate professional appearance and demeanor in accordance with Company policies.
• Keeps commitments and keep direct supervisor informed of work progress, timetables, and issues.
• Maintains strict compliance with State, Federal and other regulations (e.g., OSHA, WC, HIPAA, ADA, FEHA, DOL, HR policies and practices).
• Other duties as assigned by management.

Requirements

QUALIFICATIONS:

REQUIRED:  Bachelor's Degree in related field; minimum of five (5) years of experience in the Healthcare Industry, including staff management experience; or equivalent combination of education and work experience.

DESIRABLE:  Master’s Degree or Juris Doctorate preferred. Ophthalmology industry experience.

CERTIFICATES/LICENSES/REGISTRATIONS: 

• Certified in Healthcare Compliance (CHC) preferred.

KNOWLEDGE/SKILLS/ABILITIES/TALENTS:

• Effectively and consistently communicates with to staff encourage interactive discussions and maintains an open-door policy. 
• Models professionalism by maintaining effective working relationships, following all policies and procedures and approaching challenges with a proactive and positive attitude. Also develops strong, trusted relationships with colleagues and customers.
• Ability to analyze problems, implement acceptable solutions and provide continuous process improvements.
• Maintains the confidentiality of all business documents and correspondence.
• Results driven; aligns and allocates time and energy on key drivers. 
• Ability to identify and resolve issues in a timely and proactive manner.

Leadership 

• ­ Clearly communicates vision and aligns team members around it 
• ­ Provides continual, direct feedback; coaching vs. directing.
• ­ Appropriately delegates authority and responsibility, and holds accountable.
• ­ Recognizes and celebrates success.
• ­ Ability to develop trusting, mutually-respectful relationships with professionals. 
• ­ Tailors coaching style to the individual’s needs and appropriate professional boundaries (e.g., clinicians).

Strategic Planner

• ­ Sets realistic monthly, quarterly, and annual objectives; measures and communicates monthly results.
• ­ Prioritizes work and time/schedule to achieve business objectives.
• ­ Plans ahead (6-12months) to anticipate and overcome potential obstacles to success.

Effective Collaborator with Peers and Support Resources

• ­ Oriented towards team success; effectively communicates needs and expectations.
• ­ Shares best practices; innovates to improve operational processes; resourceful; optimistic; humble.

• Detail oriented, organized, process focused, problem solver, self-motivated proactive, customer service focused.
• Displays independent judgment by willingness to make timely and accurate decisions based on available information that is sometimes vague or limited in nature. 
• Ability to multitask effectively and work in a fast paced and sometimes ambiguous environment, without compromising quality of work.
• Ability to prioritize tasks and projects with limited direction, while understanding and contributing to the success of the organization

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. 

• This is primarily an office classification. Temperature conditions are controlled with limited direct exposure to hazardous physical substances. The noise level in the work environment is usually low to moderate.  
• While performing the duties of this job, the employee is regularly required to sit, stand, walk, handle, or feel, reach with hands and arms, see, talk and hear.  
• The employee will frequently lift and/or carry reports, records and other materials that typically weigh less than 20 pounds. The employee is occasionally required to stoop, kneel, bend, or crouch. 
• Finger dexterity is needed to access, enter, and retrieve data using a computer keyboard, calculator, and other standard office equipment.

All of the information contained herein reflect general details as necessary to describe the principal functions of this classification, the level of knowledge and skill typically required and the scope of responsibility, but should not be considered an all-inclusive listing of work requirements. Management reserves the rights to add, modify, change, or rescind the duties and/or work assignments of all positions, without advanced notice, and to make reasonable accommodations so that qualified employees can perform the essential functions of the job.

Notwithstanding any of the foregoing described job responsibilities, employee shall not engage in activities that constitute the practice of ophthalmology as prohibited under applicable law. Employee shall neither exercise control over nor interfere with the clinician-patient relationship. Clinicians shall have sole responsibility for all professional services provided to patients.