Compliance Auditor; Non-Clinical

Compliance Auditor (Non-Clinical)
St. Croix Hospice

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ix Hospice we guide patients and families through the end‑of‑life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter.

The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross‑functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen internal controls.

• Compliance Audit Program Development and Execution
  • Assist with the development and implementation of a comprehensive compliance audit program tailored to meet the requirements of CMS, Medicaid, Medicare, Medicare Advantage plans, other government payors, private insurers, the Office of Inspector General (OIG) and the Department of Justice (DOJ).
  • Develop audit frameworks, methodologies and policies that align with regulatory requirements and best practices within healthcare.
  • Ensure audits are thoroughly documented and findings are reported with corrective action recommendations.
  • Assist with the establishment of a continuous monitoring system for compliance risks and policy effectiveness.
• Risk Assessment, Audits and Internal Controls
  • Assist with enterprise‑wide risk assessments to identify gaps with federal and state laws and regulations and internal policies.
  • Conduct risk‑based audits to assess the effectiveness of internal controls and adherence to internal policies.
  • Develop risk mitigation strategies and ensure corrective action plans are implemented.
  • Collaborate with departments such as Legal, Human Resources, Finance, IT, Quality, Billing and Coding to enhance internal controls and address and remediate compliance risks.
  • Provide guidance to operational teams on improving processes to ensure compliance with federal and state laws and regulations and internal policies.
  • Monitor emerging regulatory trends and enforcement actions to proactively address potential risks.
• Policy Development and Training
  • Draft and update audit related policies, procedures and guidelines.
  • Provide guidance on internal controls, regulatory requirements and audit best practices.
  • Develop and deliver compliance audit training and education to employees on regulatory requirements, compliance best practices and audit procedures.
• Investigations and Corrective Actions
  • Oversee internal investigations related to risk assessment and/or audit findings, conducting root cause analysis to identify trends or patterns of non‑compliance.
  • Develop corrective action plans (CAPs) and track their implementation.
  • Ensure confidentiality and integrity in all investigations and reporting.
  • Work closely with Legal, Human Resources and Risk Management teams to conduct investigations and recommend disciplinary action, as applicable.
• Regulatory Compliance and Reporting
  • Ensure compliance with relevant federal and state regulations including, but not limited to, Stark Law, Anti‑Kickback Statute, Civil Monetary Penalty Authorities, Exclusion Authorities, Criminal Health Care Fraud Statute, and state‑specific regulations.
  • Oversee regulatory reporting requirements and respond to inquiries from auditors, regulators and enforcement agencies, collaborating with St. Croix Hospice leadership and General Counsel.
  • Prepare audit reports, present findings and recommended corrective actions to executive leadership, the Compliance Committee and the board of directors.
• Leadership and Collaboration
  • Serve as a trusted advisor to the Chief Compliance Officer, executive team and leadership.
  • Foster a…