Senior VP Chief Compliance and Privacy

Appalachian Regional Healthcare•Lexington, KY

About The Position

This role is responsible for building and maintaining strong relationships with stakeholders to lead an effective compliance program within the organization by fostering trust, enhancing communication, and promoting a culture of compliance. The Chief Compliance & Privacy Officer serves as a trusted advisor to management and board governance, offering guidance and practical solutions to complex regulatory compliance challenges. The Chief Compliance Officer is accountable for directing all functions related to the ARH Corporate Compliance Program and manages the day-to-day operation of the compliance program.

Requirements

Bachelor’s degree in healthcare administration, law, business, or a related field (required)
Minimum of 8 years of experience in healthcare compliance, preferably within a healthcare system, or externally providing legal services in the area of healthcare compliance to healthcare systems.
Excellent oral and written communication skills; acute attention to detail.
Great interpersonal skills, including diplomacy and flexibility, and the ability to interface effectively and engender trust and confidence with personnel internally and externally to ARH.
High degree of personal integrity and credibility.
Strong knowledge of healthcare laws, regulations, and standards, including CMS, HIPAA, Stark Law, and AKS.
Demonstrated experience leading investigations, audits, and compliance programs.
Exceptional leadership and analytical skills.
Enthusiasm and aptitude for collaboration, and partnership with business leaders and the field teams delivering the service.
The ability to set overall strategic direction while also managing the day-to-day operations of the program

Nice To Haves

Juris Doctor (JD) or master’s in healthcare administration (MHA) strongly preferred
Certified in Healthcare Compliance (CHC) or similar designation strongly preferred.

Responsibilities

Serves as the Chief Privacy Officer for the System and its subsidiaries.
Design, implement, and manage comprehensive compliance programs and policies to ensure adherence to all relevant laws, regulations, and internal standards.
Recommends solutions and ensures implementation of solutions to eliminate or minimize reoccurrence of misconduct or non-compliance.
Regularly reviews the Compliance Program for effectiveness and recommends appropriate revisions and modifications, including advising leadership and the Board Compliance Committee of areas of potential compliance risk.
Provides direction and oversight to conflicts of interest reporting and resolution process for management and governing boards.
Provides direction and support to team members to ensure effectiveness and efficiency. Selects, trains, develops, and evaluates compliance team members and initiates personnel actions in accordance with human resources policies and organization philosophy.
Regularly review and update policies and procedures to reflect changes in laws, regulations, and best practices.
Develop, maintain, and oversee the Corporate Compliance Committee, composed of senior management from multiple disciplines across ARH, to implement all necessary actions to ensure achievement of the objectives of an effective compliance program by means of reviews, relevant training, a system of consistent enforcement of the rules and the development/implementation of corrective action plans.
Prepares annual budget information related to compliance and audit levels of effort, for use by the President in controlling expenditures and making effective use of financial resources.
Develop and oversee internal and external auditing functions and risk assessments to identify potential vulnerabilities and gaps in the compliance program, including audits related to billing, coding, privacy, and operational compliance.
Lead investigations of potential compliance issues and coordinate responses and remediation plans.
Develop and deliver ongoing compliance training for providers, staff, and leadership.
Promote awareness of the compliance program through regular communication and education initiatives.
Provide guidance and support to clinical and administrative departments regarding compliance matters.
Monitor and respond to regulatory developments and industry trends.
Interfaces with in-house and external legal counsel as appropriate to interact with external regulatory agencies. Collaborates with in-house and external legal counsel in conducting, authorizing and/or overseeing investigations of matters that merit investigation under the Compliance Program. From time to time, performs investigations at the direction of legal counsel and works with legal counsel in the course of such investigation to provide guidance, recommendations and other assistance as requested by legal counsel. In such cases, the work with legal counsel shall be confidential and protected from disclosure by the attorney client privilege and work product protection.
Maintains an effective working relationship with internal departments, ARH facilities, other health care organizations and programs.
Acts in the role of Executive Secretary of the ARH Corporate Compliance Committee in reporting results of the compliance/ethics efforts of the corporation; and in providing oversight and guidance for the Board, President, Chief Legal Officer, and senior management on matters relating to compliance. In this capacity, prepares periodic reports to senior management and to the Board as directed by the President and the Compliance Committee of the Board of Trustees.
Manage the compliance hotline and incident reporting mechanisms.
Maintain documentation of investigations and ensure timely resolution and reporting.
Assures rules, regulations, policies, procedures, and Corporation’s Standards of Conduct are enforced, and where appropriate assures proper reporting of potential violations of law.
Assist in compliance elements related to physician credentialing, licensing, and other regulatory certifications.
Perform other duties as assigned by the President/CEO, Chief Legal Officer, and/or Board Compliance Committee.