Vice President of Compliance

DETROIT WAYNE Integrated HEALTH Network•Detroit, MI

1d•Onsite

About The Position

The Vice President of Compliance oversees the Corporate Compliance Program, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the Detroit Wayne Integrated Health Network (DWIHN). Reporting directly to the DWIHN CEO and its Board of directors, the Vice President of Compliance ensures that the Board, management and employees are in compliance with the rules and regulations of regulatory agencies, that DWIHN policies and procedures are being followed, and that behavior in the organization meets the Network’s Standards of Conduct.

Requirements

Demonstrated leadership ability and ability to communicate effectively orally and in writing.
Knowledge of health care law, regulations and standards.
Knowledge of coding and reimbursement systems, risk management and performance improvement.
Knowledgeable of governmental compliance regulations.
Knowledge of health care fraud and abuse laws, including the False Claims Act, Stark Laws, and Anti-Kickback Statute, including the association penalties.
Knowledge of requirements under Corporate Integrity Agreements (CIAs) and Certificate of Compliance Agreements (CCAs), HIPAA, and EMTALA.
Master’s degree in Business Administration, Healthcare Administration or related field, Juris Doctor preferred.
Certified Healthcare Compliance Officer (CHC), through Health Care Compliance Association, preferred.
A minimum of 5 years of experience as Compliance Officer, in a health care organization preferred.

Nice To Haves

Juris Doctor preferred.
Certified Healthcare Compliance Officer (CHC), through Health Care Compliance Association, preferred.
in a health care organization preferred.

Responsibilities

Serves as a channel for communication to receive and direct compliance issues to appropriate resources for investigation and resolution.
Serves as a final internal resource with which concerned parties may communicate after other formal channels and resources have been exhausted.
Develops, initiates, 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 operation of the compliance program.
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 (for example, human resources, HIPAA security officer and Chief Information Officer) to direct compliance issues to appropriate existing channels for investigation and resolution.
Consults with general counsel as needed to resolve difficult legal compliance issues.
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 and 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 and 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, keeps the Corporate Compliance Committee and senior management informed of the operation and progress of compliance efforts.
Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate or required.
Establishes and provides direction and management of the compliance hotline.
Institutes and maintains an effective compliance communication program for the organization, including promoting a) use of the compliance hotline, b) heightened awareness of standards of conduct, and c) understanding of new and existing compliance issues and related policies and procedures.
Works with the human resource department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees and ongoing training for all employees and managers.
Monitors the performance of the compliance program and related activities on a continuing basis, taking appropriate steps to improve its effectiveness.
Routinely monitor changes in the applicable HIPAA government regulations. Research and analyze available sources of regulatory guidance in response to specific questions.
Consistently monitor available sources of regulatory guidance to proactively address the necessary changes to HIPAA compliance implementation plan based on documentation and feedback.
Responds to specific questions that affect the HIPAA compliance implementation plan, with recommendations that are supported by applicable regulatory and/or government and Network policy guidance.
Maintains a strong working knowledge of applicable regulatory guidelines to be viewed as a credible resource for the Network.
Coordinates with the appropriate administrative and support departments to adequately design an implementation plan, policies and analyze the effects of any proposed process changes required by HIPAA.
Coordinates the systematic reviews of the various departments' HIPAA compliance status.
Other related duties as assigned.