VP & Compliance Officer - Full Time - Wolf River

West Cancer Center•Germantown, TN

22h

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, including identifying, assessing, monitoring, investigating, and remediating compliance risks. The officer advises the Chief Executive Officer, senior leadership, providers, employees, and other stakeholders on compliance matters and serves as the organization’s primary HIPAA Privacy Officer, overseeing its privacy compliance program. The position leads compliance risk assessments and risk-based work plans; develops and maintains policies and training; oversees auditing, monitoring, investigations, and remediation; and coordinates responses to external audits and inquiries. It monitors regulatory changes and oversees compliance efforts related to healthcare regulations, fraud, waste and abuse, and HIPAA. The officer reports significant risks and program results to leadership and applicable Board committees, participates in governance and other committees, and maintains appropriate independence and access to information needed to fulfill the role. 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 of up to 25 pounds occasionally or 10 pounds frequently, and close visual acuity for tasks such as data analysis, computer use, and extensive reading. The job posting states there are no nights, weekends, or holidays.

Requirements

Bachelor’s degree in Business, Healthcare Administration, Compliance, or a similar field.
At least 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.

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 remain accountable for West Cancer Center’s healthcare compliance program, including its establishment, operation, and continuous improvement.
Conduct or oversee annual compliance risk assessments, develop risk-based work plans, and establish metrics and reporting processes to evaluate program effectiveness.
Develop, review, implement, and maintain compliance policies and procedures in collaboration with organizational 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 findings and oversee appropriate remediation.
Receive and evaluate reports of potential violations or significant compliance risks; conduct or oversee investigations and assess their scope, root cause, and impact.
Develop and monitor remediation plans addressing regulatory violations, process deficiencies, control weaknesses, and systemic risks; recommend measures to mitigate risk and prevent recurrence.
Escalate significant or unresolved compliance concerns to the Chief Executive Officer and coordinate with Human Resources when investigations identify related employee misconduct. Human Resources retains responsibility for employment or disciplinary action.
Monitor and communicate changes in healthcare laws, regulations, regulatory guidance, and enforcement priorities, and provide compliance guidance to leadership, providers, and departments.
Oversee fraud, waste, and abuse compliance activities, 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 the primary HIPAA Privacy Officer; oversee the privacy compliance program and monitor compliance with HIPAA Privacy, Security, and Breach Notification requirements.
Oversee privacy complaints, suspected unauthorized access or use or disclosure of protected health information, and potential breaches; coordinate investigation, mitigation, documentation, and required reporting.
Provide regular reports 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 and 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.