VP & Compliance Officer - Full Time - Wolf River

West Cancer Center•Germantown, TN

18d

About The Position

The VP & Compliance Officer is a member of West Cancer Center’s leadership team and provides independent, objective leadership of the organization’s healthcare compliance program. The role is accountable for establishing, implementing, operating, and continually improving the program and its effectiveness. It oversees the identification, assessment, monitoring, investigation, and remediation of compliance risks, and advises the Chief Executive Officer, senior leadership, providers, employees, and other stakeholders on compliance matters. The position also serves as the organization’s primary HIPAA Privacy Officer and oversees its privacy compliance program. The position leads compliance risk assessments and risk-based work plans; develops and maintains policies, education, auditing, and monitoring; coordinates responses to external audits and inquiries; oversees investigations and corrective actions; and monitors applicable healthcare laws and enforcement priorities, including requirements concerning fraud, waste, and abuse. It provides governance reporting and helps foster an environment where concerns are reported, investigated, and addressed. The role maintains appropriate independence and access to the records, systems, personnel, and information needed to fulfill its responsibilities. The work is typically performed in a general office or administrative environment and is not substantially exposed to adverse environmental conditions. Physical activities may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion. The role requires good balance and coordination, light exertion, and close visual acuity for tasks such as analyzing data, using a computer terminal, and extensive reading.

Requirements

Bachelor’s degree in Business, Healthcare Administration, Compliance, or a similar field.
Minimum of five years of progressive healthcare compliance or related experience.
Experience administering a healthcare compliance program, including risk assessment, auditing, monitoring, investigations, and remediation.
Experience working with physicians, executive leadership, employees, and governing bodies.
Strong knowledge of healthcare laws, regulations, regulatory requirements, compliance principles, HIPAA, and fraud, waste, and abuse requirements.
Knowledge of healthcare billing, coding, documentation, reimbursement, medical necessity, and related regulatory risks.
Strong analytical, investigative, critical-thinking, and problem-solving skills.
Excellent written and verbal communication skills, including the ability to explain complex regulatory requirements to diverse audiences.
Demonstrated integrity, sound judgment, discretion, independence, and objectivity.
Ability to identify and appropriately address compliance risks and challenge practices when warranted.
Ability to manage confidential and sensitive information.
Ability to work effectively with physicians, providers, executives, managers, employees, and external regulatory and oversight entities.
Physical activities may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
Must have good balance and coordination.
Light work requiring exertion of up to 25 pounds occasionally and/or up to 10 pounds frequently.
Close visual acuity is required for activities such as preparing and analyzing data and figures, transcribing, viewing a computer terminal, and extensive reading.

Nice To Haves

Master’s degree, JD, or other relevant master’s degree.
Certified in Healthcare Compliance (CHC), CHPC, CHRC, CCEP, CIA, CPC, or another compliance, auditing, or privacy credential.

Responsibilities

Lead and serve as the accountable owner of West Cancer Center’s healthcare compliance program.
Establish, maintain, and continuously improve an effective compliance program consistent with applicable laws, regulations, regulatory guidance, and recognized compliance practices.
Conduct or oversee annual compliance risk assessments and develop risk-based compliance work plans.
Identify compliance risks and recommend controls, education, monitoring, and risk mitigation strategies.
Establish compliance metrics and reporting processes to evaluate program effectiveness.
Develop, review, implement, and maintain compliance policies and procedures with appropriate leaders and subject matter experts.
Oversee compliance education and training and promote ethical conduct, regulatory awareness, and non-retaliation.
Develop and oversee risk-based compliance auditing and monitoring, including billing, coding, documentation, reimbursement, medical necessity, provider arrangements, privacy, and other identified risk areas.
Coordinate responses to governmental, regulatory, accreditation, payer, and other external audits or inquiries.
Evaluate audit and monitoring results and oversee appropriate compliance remediation.
Receive and evaluate reports of potential violations or conduct that may create significant compliance risk.
Conduct or oversee compliance investigations and coordinate with Human Resources, operational leadership, or other appropriate parties as needed.
Evaluate the scope, root cause, and potential impact of substantiated compliance concerns.
Develop and monitor remediation plans addressing regulatory violations, process deficiencies, control weaknesses, and systemic risks.
Recommend improvements to policies, procedures, controls, workflows, education, and monitoring to mitigate risk and prevent recurrence.
Escalate significant or unresolved compliance concerns to the Chief Executive Officer.
Coordinate with Human Resources when an investigation identifies employee misconduct directly related to the compliance concern; Human Resources retains responsibility for disciplinary or other employment action.
Monitor and communicate changes in applicable healthcare laws, regulations, regulatory guidance, and enforcement priorities.
Provide compliance guidance to leadership, providers, and departments regarding regulatory requirements and identified risks.
Oversee fraud, waste, and abuse compliance activities, including requirements under the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, and Medicare and Medicaid programs.
Coordinate appropriate investigation, remediation, reporting, disclosure, and repayment activities when potential fraud, waste, or abuse is identified.
Serve as the primary HIPAA Privacy Officer and oversee the privacy compliance program.
Monitor compliance with HIPAA Privacy, Security, and Breach Notification requirements.
Oversee privacy complaints, suspected unauthorized access, use or disclosure of protected health information, and potential breaches.
Provide guidance on appropriate use and disclosure of protected health information and coordinate investigation, mitigation, documentation, and required reporting of privacy incidents.
Report regularly to the Chief Executive Officer, senior leadership, and/or applicable Board committee on significant compliance risks, investigations, audit findings, remediation, and program effectiveness.
Provide independent, objective advice on significant compliance risks and emerging regulatory issues.
Participate in appropriate leadership, governance, risk, privacy, quality, and other committees.
Maintain appropriate independence and access to records, systems, personnel, and information necessary to fulfill compliance responsibilities.
Foster a culture in which compliance concerns are identified, reported, investigated, and appropriately addressed.