Technical Lead, Corp Compliance (Lab)
About The Position
This position supports the Manager of Compliance for DaVita Labs and assists in existing and new compliance activities. The Technical Lead is responsible for identifying, developing, and implementing strategies to mitigate risk in a developing healthcare regulatory landscape, with a key focus on Fraud, Waste, and Abuse (FWA) laws like the False Claims Act (FCA) and record retention policies. This role combines deep expertise in revenue cycle processes and End-Stage Renal Disease (ESRD) billing rules with broader compliance program support. The position involves conducting focused reviews of medical records, billing data, and clinical systems to ensure services are generated and billed in accordance with established policies and regulatory requirements. This teammate will perform complex data analysis, lead projects, provide daily compliance guidance, and collaborate with business and legal partners to foster a proactive approach to compliance.
Requirements
- Bachelor’s degree or equivalent relevant work experience required.
- Minimum five (5) years of Revenue Cycle or relevant experience required, preferably in a healthcare business setting.
- Minimum of three (3) years audit experience required
- Fluent in the written and verbal skills necessary to successfully perform the essential functions, duties, and responsibilities of the position.
Nice To Haves
- Preferred experience working with Medicare regulations, healthcare billing or coding and respective electronic health records and billing IT systems.
- Intermediate knowledge of Structured Query Language (SQL) or Oracle PL/SQL preferred.
- Healthcare Compliance Certification (e.g., CHC-HCCA, CPCO-AAPC) is preferred.
- Certified Medical Coder certification preferred (CPC, CCS, CMC)
- Data analytics or visualization certification (e.g., Tableau) or database certification (e.g., SQL, Oracle) preferred.
Responsibilities
- Support the annual compliance risk assessment and implementation of the compliance plan.
- Develop, review, and update policies, training materials, and other communications to address compliance risks.
- Develop and conduct focused assessments of billing, laboratory, and clinical systems to ensure compliant practices.
- Perform complex data analysis to identify trends and risks, conduct post-audit reviews of system updates, and develop comprehensive written reports on findings for stakeholders.
- Assist in compliance investigations to identify root causes and implement corrective action.
- Lead the full lifecycle of monitoring and inquiry cases within the case management system, including tracking corrective actions through completion.
- Develop strong, collaborative relationships with business partners, Senior Lab Leadership, and Legal to foster proactive compliance and implement strategies for process improvement.
- Provide daily compliance guidance on matters involving federal healthcare program laws.
- Develop and maintain charge mapping oversight activities to ensure accurate chargemaster setup and maintenance.
- Manage communications regarding these systems across various laboratory and non-laboratory platforms.
- Work independently on special projects, help with the implementation of new processes and controls, and maintain databases that support compliance reporting needs.
- Support the development of quarterly Management Compliance Committee materials, preparing presentations on data findings and strategies.
- Lead various compliance education and engagement initiatives.
- Must be self-motivated, team player with proven ability to identify issues and manage priorities in a fast-paced environment while striving for practical business solutions.
- Ability to handle confidential information and/or issues using discretion and judgment.
- Other Duties as Assigned
Benefits
- Medical, dental, vision, 401(k) match, paid time off, PTO cash out
- Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
- DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
