Director of Compliance Southwestern Health Resources

UT Southwestern Medical Center • Dallas, TX

7d

About The Position

The Director oversees the day-to-day activities of the corporate compliance program, functioning as an independent and objective body. This position oversees compliance for Southwestern Health Resources Accountable Care Network. The Director evaluates compliance with Company policies, laws, and regulations, as well as investigates issues/concerns within the organization. The position provides strategic direction to management on compliance and is responsible for ensuring that the Company compliance program is effective and efficient in identifying, preventing, detecting, and correcting noncompliance. This position reports directly to the Chief Compliance Officer for SWHR/UT Southwestern. The Director exists: As a channel of communication to receive and report on compliance issues and use appropriate resources for investigations and applicable resolution; to provide guidance to the Company on policies, laws and regulations, compliance risks and leading compliance practices; to assist the business units in assessing internal strengths, weaknesses and helping close gaps to ensure Company objectives are met; and to, along with Company leadership, create a culture of compliance within the organization. The Director, together with the Chief Compliance Officer and the Corporate Compliance Committee and Audit and Compliance Committee of the Board, is authorized to implement all necessary actions to ensure achievement of the objectives of an effective compliance program.

Requirements

• Bachelor's Degree in Healthcare Administration, Business, or a related field
• 5 years of management experience in Healthcare Compliance or related field.
• May consider higher education completed in lieu of minimum requirements.
• (CHC) CERTIFIED HEALTHCARE COMPLIANC
• Thorough knowledge of state and federal guidance, laws and regulations, industry leading practices, accreditation bodies, participating provider agreements, HIPAA and Third-Party Administration (TPA) laws, credentialing regulations, prompt pay laws, and fraud, waste, and abuse (FWA) laws.
• Work requires ability to monitor and maintain budget.
• Work requires ability to plan and organize work in logical and efficient manner.
• Work requires ability to ensure adherence to all policies and procedures of university, such as, salary guidelines, accounting regulations, and internal controls policy.
• Work requires ability to work with confidential information on daily basis.
• Work requires excellent oral and written communication skills.

Nice To Haves

• Master's Degree in Healthcare Compliance

Responsibilities

• Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent, detect, and correct illegal, unethical, or improper conduct.
• Develops and routinely reviews and updates, as necessary, the Compliance Plan and Code of Conduct to ensure continuing currency and relevance in providing compliance guidance to management and employees.
• Acts as an independent review and evaluation body to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated, and resolved. Collaborates with other departments (e.g., Risk Management, HR, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with internal and external counsel, as needed, to resolve difficult legal compliance issues.
• Performs and/or oversees annual compliance risk assessment to identify organizational risks. Based on the results of the risk assessment, works with leadership on creation of risk profile, metrics, workplan and corrective actions.
• Provides reporting on a regular basis, and as directed or requested, to keep the Corporate Compliance Committee, Compliance and Audit Committee of the Board, Board of Trustees and senior management informed of the operation and progress of compliance efforts.
• Monitors key performance and risk indicators/metrics to assist with early identification of risk trends across various operational units.
• Institutes and maintains an effective compliance communication program for the organization, including promoting use of the Compliance Hotline and retaliation-free reporting; promotes awareness of Code of Conduct and understanding of new and existing compliance issues and related polices and procedures.
• Partners with Human Resources and others as appropriate to develop an effective compliance training program for newly hired employees and annual refresher training for existing employees.
• Oversees coordination of external compliance audits from entities providing oversight, including but not limited to Contracted Payors, State Departments of Insurance, and CMS.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees