Billing and Audit Compliance Program Manager

Johns Hopkins Medicine•Baltimore, MD

27d•$40 - $64

About The Position

The Compliance Program Manager is responsible for the development, implementation, and ongoing monitoring of the Corporate Compliance Program with a particular emphasis on federal payor billing compliance and compliance related education for the Johns Hopkins Health System Corporation and its affiliates. Critical to the success of this role, the Compliance Program Manager is responsible for independently assessing a variety of complex compliance risk-areas within the JHHS affiliates to develop the Compliance Department's work plan. Responsible for independently performing scheduled audits required by the work plan, unplanned investigations and in carrying out these activities independently providing compliance guidance to JHHS personnel. He/she using judgment and critical thinking skills in determining appropriate corrective action for non-compliance as well as ensures that corrective action is taken by the affiliate. Additionally, responsible for monitoring and responding to certain regulatory requests and representing the Compliance Department on various committees as requested. This position will be providing regular guidance and advice to JHHS personnel, leadership and Executive Management in compliance related areas. Conducting independent research in the areas of Medicare and Medicaid and other complex legal authorities pertaining to billing and regulatory compliance. Responsibilities include the developing education and training for management and staff regarding federal payor regulatory requirements and other compliance matters based on the incumbent's independent judgment of the affiliate's educational needs. This position will also be managing audits conducted by vendors and payers and provide regular status reports to senior management. Additionally, he/she will be responsible for reviewing the draft work product of their peers and to mentor and assist in the training and development of the compliance staff

Requirements

Requires a minimum of a Bachelor's degree.
Requires a minimum of five (5) years' experience in health care (clinical or otherwise), coding, auditing, utilization management or related experience.