Director, Provider Compliance

Position Summary

The Director of Provider Compliance is responsible for the implementation of the comprehensive Provider Compliance Program. The role will advise leaders and team members on matters that contribute to adherence of regulatory matters impacting provider agreements and compensation. The leader will support business enablement and value creation while utilizing a predictive approach to risk management.

FTE: 1.0,

Shift: Day,

Schedule:

Business Hours

• Develop and execute provider compliance program activities to include contract review and consultation, compensation audits and reviews, policy develop and education, and issue management.
• Oversee the provider compliance program risk assessment process. Collaborate with leaders to implement appropriate monitoring activities to validate adherence to regulatory and contractual matters.
• Participate in conversations to analyze and review compensation matters, (i.e., fair market value, payment practices, documentation, etc.).
• Develop action plans in response to internal audits, external reviews and government inquiries.
• Monitor and provide guidance for regulatory changes. Collaborate with appropriate leadership to ensure changes are implemented as necessary.
• Oversee compliance with provider-based departments requirements.
• Chair and/or participate in compliance committees.

• Bachelor’s degree in accounting, finance, business, legal studies or related field required
• Graduate degree in business, finance, health care management or related field or advanced certification preferred
• Certification preferred (CHC, CPA, CIA, CFE)
• Minimum eight (8) years of professional experience in compliance, auditing, legal, accounting or finance in the health care industry
• Minimum five (5) years of experience in a supervisory or lead capacity

We provide a comprehensive benefits package, including competitive salary, medical, dental and retirement benefits and paid time off. As required by various pay transparency laws, we share a competitive range of compensation for candidates hired into each position. The pay scale is $ - $ USD. However, pay is influenced by factors specific to applicants, including but not limited to: skill set, level of experience, and certification(s) and/or education.

If this position is associated with a union contract, pay will be reflective of the appropriate step on the pay scale to which the applicant’s years of experience align.

Associated benefit information can be viewed here.