Corporate Compliance Officer

Virginia Information Technologies Agency • Roanoke County, Virginia, VA

18h • $59,754 - $113,000 • Onsite

About The Position

Provides facility-level leadership for compliance, utilization review, privacy, quality/risk management, investigations, and regulatory readiness. Supervises Utilization Review Coordinators and the ADA Coordinator while ensuring performance management requirements are met and staff receive appropriate direction, feedback, evaluation, and accountability.

Develops, implements, and maintains the facility’s Medicare Voluntary Compliance Program in accordance with applicable Federal and State health care laws and regulations, including CMS Conditions of Participation. Oversees internal compliance audits, identifies compliance vulnerabilities and risks, develops corrective action plans, maintains compliance policies and procedures, manages the compliance hotline, and conducts the annual compliance program audit. Coordinates The Joint Commission (TJC) Mock Survey Process and serves as the facility’s TJC Chapter Champion, supporting ongoing assessment of standards and Elements of Performance (EPs).

Ensures required administrative records, reports, committee responsibilities, and regulatory activities are accurate, timely, and complete. Participates in facility committees, including Quality Council, Corporate Compliance, Ethics, and Health Information Management (HIM), and serves as a liaison with internal departments, other facilities, and regulatory agencies. Conducts and coordinates internal and external audits to assess compliance with policies, procedures, and regulatory requirements.

Develops and maintains comprehensive compliance education and training for physicians, non-physician providers, and other employees, with emphasis on documentation, coding, billing, and Federal and State health care program requirements. Maintains current regulatory resources and communicates changes in applicable requirements, policies, and procedures.

Serves as the facility’s Informal Complaint Representative, investigating patient complaints and working with patients, families, legal representatives, Human Rights Advocates, and staff to achieve appropriate resolution while applying population-specific regulatory requirements. Conducts and documents internal investigations involving suspected compliance violations and assists Risk Management with Root Cause Analyses (RCAs) and other investigations, including required external reporting.

Serves as the facility HIPAA Privacy Officer, ensuring implementation of HIPAA Privacy Rule requirements and facility privacy policies; reviewing business associate provisions; coordinating workforce privacy training; addressing privacy complaints and potential breaches; consulting with the Department’s Chief Privacy Officer and the Office of the Attorney General when appropriate; and providing required privacy reports and summaries.

Requirements

• Comprehensive knowledge of Medicaid and Medicare administration policies and practices
• Comprehensive knowledge of Clinical Documentation
• Comprehensive knowledge of Administration and training principles and practices
• Comprehensive knowledge of Applicable Federal, State and Departmental laws, regulations and policies
• Comprehensive knowledge of Basic mathematical and statistical techniques
• Skills include: Problem Identification
• Skills include: Information Gathering
• Skills include: Organization
• Skills include: Critical Thinking
• Skills include: Interpersonal Diplomacy/Professionalism
• Skills include: Idea Generation
• Abilities include: Written and verbal comprehension
• Abilities include: Written and verbal communications
• Abilities include: Extensive PC use
• Abilities include: Deductive and Inductive Reasoning
• Abilities include: Problem sensitivity

Nice To Haves

• Certification in related field highly desired (i.e. CCEP, CPHQ, CPHRM)
• Previous experience in a healthcare setting highly desired.
• Experience assisting with regulatory surveys required (i.e. Joint Commission, CMS, VDH, OSIG).

Responsibilities

• Provides facility-level leadership for compliance, utilization review, privacy, quality/risk management, investigations, and regulatory readiness.
• Supervises Utilization Review Coordinators and the ADA Coordinator while ensuring performance management requirements are met and staff receive appropriate direction, feedback, evaluation, and accountability.
• Develops, implements, and maintains the facility’s Medicare Voluntary Compliance Program in accordance with applicable Federal and State health care laws and regulations, including CMS Conditions of Participation.
• Oversees internal compliance audits, identifies compliance vulnerabilities and risks, develops corrective action plans, maintains compliance policies and procedures, manages the compliance hotline, and conducts the annual compliance program audit.
• Coordinates The Joint Commission (TJC) Mock Survey Process and serves as the facility’s TJC Chapter Champion, supporting ongoing assessment of standards and Elements of Performance (EPs).
• Ensures required administrative records, reports, committee responsibilities, and regulatory activities are accurate, timely, and complete.
• Participates in facility committees, including Quality Council, Corporate Compliance, Ethics, and Health Information Management (HIM), and serves as a liaison with internal departments, other facilities, and regulatory agencies.
• Conducts and coordinates internal and external audits to assess compliance with policies, procedures, and regulatory requirements.
• Develops and maintains comprehensive compliance education and training for physicians, non-physician providers, and other employees, with emphasis on documentation, coding, billing, and Federal and State health care program requirements.
• Maintains current regulatory resources and communicates changes in applicable requirements, policies, and procedures.
• Serves as the facility’s Informal Complaint Representative, investigating patient complaints and working with patients, families, legal representatives, Human Rights Advocates, and staff to achieve appropriate resolution while applying population-specific regulatory requirements.
• Conducts and documents internal investigations involving suspected compliance violations and assists Risk Management with Root Cause Analyses (RCAs) and other investigations, including required external reporting.
• Serves as the facility HIPAA Privacy Officer, ensuring implementation of HIPAA Privacy Rule requirements and facility privacy policies; reviewing business associate provisions; coordinating workforce privacy training; addressing privacy complaints and potential breaches; consulting with the Department’s Chief Privacy Officer and the Office of the Attorney General when appropriate; and providing required privacy reports and summaries.

Benefits

• Reasonable accommodations are available to individuals with disabilities during the application and/or interview process in accordance with the Americans with Disabilities Act.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed