HR - Corporate Compliance Director

Community Clinic Inc.•Silver Spring, MD

1d•Onsite

About The Position

CCI Health Services’ mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone. POSITION SUMMARY Under the supervision of the Chief People Officer, the Corporate Compliance Director is responsible for overseeing claims management activities, including but not limited to the management and processing of any claims-related activities and serving as the claims point of contact daily. The Corporate Compliance Director maintains the compliance function thru on-going monitoring of compliance requirements, risk assessment analysis, and business decisions that impact the compliance program and responsible for updating all relevant procedures and manuals.

Requirements

Master’s degree in human resources, Organizational Compliance, Organizational Development or a similar designation required; Juris Doctorate degree preferred.
At least three (3) years’ experience as a compliance officer or practicing ligation lawyer.
Must be well versed in the compliance environment to anticipate and prepare for potential issues and manage the risk and regulatory affairs of community clinics with offices in multiple locations.
Ability to operate as an effective tactical as well as strategic thinker.
Familiarity with operational, financial, quality assurance, and human resource procedures and regulations is a must.
Change management capabilities that can impact the CCI.
Ability to work independently and effectively.
Plan and execute long-term strategy around driving organizational change.
Knowledge of research methods and techniques utilized to assemble, organize, and present in written or oral form statistical, financial, or information derived from a variety of sources.
Knowledge of the laws, ordinances, and other requirements governing community clinics.
Strong oral and written communication skills.

Nice To Haves

Experience in health care and employment related law strongly preferred.

Responsibilities

Participates in the definition and development of corporate policies and procedures.
Serves as first responder and processor for all claims, lawsuits, subpoenas, depositions, and externally filed grievances.
Generates and reviews claims, leases, MOUs, Contracts, BAAs, and other documents as needed.
Provides knowledge and enforcement of rules, regulations and requirements for all funders and quality designations.
Assumes the ultimate responsibility for ensuring that the organization conducts its business in compliance with applicable state and federal laws and regulations.
The Corporate Compliance Director is responsible for overseeing claims management activities including but not limited to, the management and processing of any claims-related activities and serving as the claims point of contact.
Manages and oversees the claims process of the Federal Tort Claims Act (FTCA) and serves as the claims point of contact.
Develops, initiates, implements, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct. Manages day-to-day operations of the Program.
Developing policies and programs that encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.
Develops and periodically reviews and updates Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees.
Collaborates with other departments (e.g., Risk Management, Operations, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution.
Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures. Develops and oversees a system for uniform handling of such violations.
Acts as an independent review and evaluation body to ensure that compliance Issues/concerns within the organization are being appropriately evaluated, investigated and resolved.
Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future.
Provides reports on a regular basis, and as directed or requested, to keep senior management informed of the operation and progress of compliance efforts, progress of implementation, and assisting these components in establishing methods to improve efficiency and quality of services, and to reduce the vulnerability to fraud, abuse, and waste.
Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
Establishes and provides direction and management of compliance emails.
Institutes and maintains an effective compliance communication program for CCI, including promoting (a) use of the Compliance email; (b) heightened awareness of Standards of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.
Works with the departments external to Human Resources, as appropriate, to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.
Monitors the performance of the Compliance Program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness.
Advises the Chief People Officer, the Chief Executive Officer, the Board of Directors, and other senior leaders on compliance activities conducted by and/or risks facing CCI.
Presents Compliance activities and reports to senior leadership and/or the Board of Directors quarterly. More frequent reporting may be required.
Establishing a compliance committee
Developing, implementing, and monitoring the general Compliance Program education and training schedule
Developing effective lines of communication
Enforcing standards through well publicized disciplinary guidelines and developing policies addressing dealings with sanctioned individuals
Conducting periodic risk assessments and response plans
Conducting internal monitoring and auditing
Responding promptly to detect offenses, developing corrective action, and reporting findings to appropriate regulators, as appropriate, via established channels.