Director, System Compliance

Alameda Health System•Oakland, CA

12d

About The Position

The Director, System Compliance supports the Vice President, Compliance and/or Chief Compliance Officer in strategic planning, implementation, oversight, and continuous improvement of the Alameda Health System (AHS) Corporate Compliance Program. The role provides leadership for enterprise-wide compliance initiatives, regulatory risk management, auditing and monitoring, investigations, education, and compliance operations. The Director advises executive leadership and operational departments on healthcare regulatory requirements and compliance strategies, while promoting ethics, integrity, and accountability throughout the organization. The position leads the administration and improvement of the Corporate Compliance Program; oversees compliance policies, procedures, training, reporting channels, investigations, and corrective action plans; and partners with leadership, Internal Audit, the Office of General Counsel, Human Resources, and other departments. It also advises on healthcare regulations, supports responses to government and external reviews, provides guidance on privacy initiatives, represents Compliance on committees, and develops metrics and reporting on program effectiveness.

Requirements

Bachelor’s degree in Business Administration or a healthcare-related field.
Ten years of experience in a healthcare organization, including direct experience in healthcare compliance and audit procedures.
Certified in Healthcare Compliance (CHC).

Nice To Haves

Master’s degree in a related field.
Certified Healthcare Research Compliance (CHRC).
Certified Professional Coder (CPC or CCS-P).
Certified in Healthcare Privacy Compliance (CHPC).

Responsibilities

Provide strategic leadership for implementation, administration, and continuous improvement of the AHS Corporate Compliance Program.
Oversee the development, implementation, and maintenance of compliance policies, procedures, and standards.
Maintain effective processes to prevent employment or contracting of individuals and entities excluded from federal healthcare programs, including exclusion screening and vendor compliance oversight.
Direct enterprise-wide compliance education and training for the workforce, medical staff, contractors, and vendors.
Oversee confidential reporting mechanisms, including the compliance hotline, and ensure concerns are evaluated, investigated, and addressed while protecting individuals from retaliation.
Develop communications that promote awareness of the Corporate Compliance Program, Code of Conduct, ethical standards, and applicable laws and regulations.
Partner with the Vice President, Compliance and Internal Audit to develop and execute risk-based auditing and monitoring activities.
Oversee compliance investigations and collaborate with operational leadership on timely implementation, monitoring, and validation of corrective action plans.
Collaborate with executive leadership and operational departments to identify emerging compliance risks and develop policies, procedures, and internal controls.
Coordinate targeted education and corrective training based on audit findings, investigations, regulatory changes, compliance trends, and organizational risks.
Serve as a subject matter expert on healthcare regulatory requirements, including Medicare and Medicaid, fraud and abuse laws, documentation, billing and coding, clinical quality, patient safety, and privacy.
Partner with the Vice President, Compliance and Internal Audit and the Office of General Counsel in responding to government audits, investigations, regulatory inquiries, and external reviews.
Collaborate with the Office of General Counsel on regulatory compliance issues, investigations, disclosures, and legal matters.
Collaborate with Human Resources and other business partners on workforce screening, disciplinary actions, conflicts of interest, Code of Conduct enforcement, and other compliance processes.
Assist the Vice President, Compliance and Internal Audit in evaluating and maintaining an effective compliance program consistent with applicable federal guidance and regulatory authorities.
Provide strategic consultation, operational support, and executive-level assistance to the Vice President, Compliance and Internal Audit on departmental priorities, organizational initiatives, and special projects.
Provide guidance and operational support to the System Privacy Officer on privacy, confidentiality, and information governance initiatives, as appropriate.
Represent the Compliance Department on executive committees, multidisciplinary workgroups, and organizational governance committees.
Develop, monitor, and report compliance metrics, dashboards, and analytics to measure program effectiveness, identify trends, and support executive and Board reporting.
Lead strategic compliance initiatives and continuous process improvement to enhance operations, strengthen internal controls, reduce risk, and advance ethical conduct.
Perform other related duties as assigned.