Director - Healthcare Compliance - Integrity & Compliance

Director
- Healthcare Compliance
- Integrity & Compliance

Directs and monitors the institutional healthcare compliance program, with specific emphasis on healthcare compliance of the university health system.

Education and Experience

Required:

Bachelor's degree and five (5) years of compliance experience in a healthcare setting.

Certifications, Licenses or Registration required:

N/A

Preferred Qualifications:

Registered Health Information Administrator or Registered Health Information Technician certification from the American Health Information Management Association. Supervisory experience.

Knowledge, Skills, and Abilities:

Advanced knowledge of medical billing, to include billing policies and procedures for federal payers; advanced knowledge of medical coding and coding guidelines, for both professional billing and facility/institutional billing; knowledge of federal and state rules, laws, regulations, policies/procedures, etc. that are applicable to healthcare; knowledge of accounting/business principles; verbal and written communication skills; possess the ability to speak in public settings/forums;

analytical/critical thinking skills; ability to work independently and in a group setting; have knowledge about and be skilled in utilizing basic business software applications.

Responsibilities:

• Provide day-to-day management of assigned staff and providing direction to staff regarding audits, healthcare rules, laws and regulations.
• Coordinate and facilitate committee meeting, to include those compliance subcommittees that oversee compliance of the university health system.
• Stay abreast of federal and state rules, laws, regulations, policies/procedures, etc. that are applicable to healthcare, third-party billing policies/procedures to include specifically federal payers, and coding updates.
• Develops, implements, and maintains system-wide programs, policies and procedures to ensure compliance with federal and state rules, laws, regulations, policies/procedures, etc. that are applicable to healthcare.
• Develops and implements/presents training, as needed, to ensure institutional healthcare compliance. This will include both group and individual training, as necessary.
• Investigates/reviews allegations of alleged compliance plan violations, as needed or directed.
• The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Physical and Environmental Demands Requires occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, frequent work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching/stooping, occasional driving, occasional reaching, frequent sitting, frequent standing, frequent twisting, and frequent walking.

(occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)

Time Type:
Full time

FLSA Designation/Job Exempt:
Yes

Pay Class:
Salary

FTE %: 100

Work Shift:

Day

Benefits Eligibility:
Grant Funded:
No