VP & Compliance Officer - Full Time - Wolf River

West Cancer Center•Germantown, MD

3d•Onsite

About The Position

At West Cancer Center, we are committed to providing exceptional, patient-centered cancer care while maintaining the highest standards of integrity, accountability, and regulatory compliance. Our leadership team works collaboratively to promote ethical conduct, identify and address compliance risks, and support an effective compliance program throughout the organization. The VP & Compliance Officer is a key member of West Cancer Center’s leadership team and provides independent and objective leadership of the organization’s healthcare compliance program. This position is primarily responsible for the establishment, implementation, operation, and continuous improvement of the compliance program and is accountable for its effectiveness. The VP & Compliance Officer oversees the identification, assessment, monitoring, investigation, and remediation of compliance risks and serves as a resource and advisor to the Chief Executive Officer, senior leadership, providers, employees, and other stakeholders regarding compliance matters. This position also serves as West Cancer Center’s primary HIPAA Privacy Officer and oversees the privacy compliance program.

Requirements

Bachelor’s degree in Business, Healthcare Administration, Compliance, or a similar field
Minimum of five (5) 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

Nice To Haves

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

Responsibilities

Serve as the primary leader and 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 appropriate 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 in collaboration 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 indicating potential violations of healthcare laws, regulations, regulatory requirements, 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 compliance 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 a compliance investigation identifies employee misconduct directly related to the compliance concern; Human Resources retains responsibility for determining and administering 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 compliance activities related to fraud, waste, and abuse, including applicable 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 West Cancer Center’s 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 regarding the appropriate use and disclosure of protected health information and coordinate investigation, mitigation, documentation, and required reporting of privacy incidents
Provide regular reports to the Chief Executive Officer, senior leadership, and/or applicable Board committee regarding significant compliance risks, investigations, audit findings, remediation, and program effectiveness
Provide independent and objective advice regarding 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