Executive Director, Compliance (TEMP)

Cape Cod Healthcare • Hyannis, MA

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About The Position

1. Reports to the Chief Compliance Officer.
2. Review all payor requirements, such as National Coverage Determinations and Local Coverage Determinations and develop a plan to operationalize the requirements within the system to ensure compliance.
3. Oversees payors requirements to assure compliance with federal and state healthcare rules and regulations.
4. Partner and collaborate with Department and Senior Leadership to assure compliance with federal and state healthcare rules and regulations.
5. Conduct routine audits to assure compliance with regulatory requirements,
6. Routinely train and educate on federal and state payor healthcare rules and regulations, Compliance Work Plan and Cape Cod Healthcare policies and procedures
7. Prepare and provide reports routinely to the Chief Compliance Officer, Compliance Committee and Senior Leadership as required.
8. Create and manage any corrective action plan due to gaps and/or non-compliance identified.
9. Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
10. Challenges current working practices identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.
11. Other duties as needed.

Requirements

• Graduate of an accredited School of Nursing, Advanced degree preferred.
• Must have 5+ years of Healthcare Compliance experience.
• Must hold or obtain in 2 years a Certified in Health Care Compliance (CHC) certification.
• Understanding and knowledge of healthcare payor rules and requirements
• Ability to evaluate and educate on healthcare regulatory requirements.
• Knowledgeable of OIG’s Seven Element of a Successful Compliance Program and US Federal Sentencing Guidelines
• Prior experience presenting multiple levels of healthcare.
• Ability to read, write and communicate in English

Nice To Haves

• Previous Compliance Integrity Experience preferred.
• Certification in healthcare compliance a plus.

Responsibilities

• Review all payor requirements and develop a plan to operationalize the requirements within the system to ensure compliance.
• Oversee payors requirements to assure compliance with federal and state healthcare rules and regulations.
• Partner and collaborate with Department and Senior Leadership to assure compliance with federal and state healthcare rules and regulations.
• Conduct routine audits to assure compliance with regulatory requirements
• Routinely train and educate on federal and state payor healthcare rules and regulations, Compliance Work Plan and Cape Cod Healthcare policies and procedures
• Prepare and provide reports routinely to the Chief Compliance Officer, Compliance Committee and Senior Leadership as required.
• Create and manage any corrective action plan due to gaps and/or non-compliance identified.
• Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
• Challenges current working practices identifies process improvement opportunities and presents recommendations and solutions to management.
• Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.
• Other duties as needed.

What This Job Offers

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