Job Description

Overview:

 

The Executive Director of Facility Compliance is responsible for the direction and leadership of operational, financial, programmatic and personnel activities for the Cone Health facilities including, but not limited to, the hospitals, cancer centers, hospital-based clinics, and ancillary services.

 

The range of duties and responsibilities is broad and varied, the position’s major responsibility is directing the day-to-day operations, budgeting, financial management, and human resource management for the Cone Health facility compliance functions for the organization. Additionally, this position oversees and conducts risk assessment, root cause analysis, performance metrics, process design support, and technology implementation.

 

The Executive Director evaluates, analyzes, or assesses the risks associated with business processes such as: facility coding and billing, code of conduct, vendor relations, conflict of interest, applicable regulations, and policies. This role works collaboratively with a variety of stakeholders, coordinating the activities of compliance with all levels of employees across the Cone Health enterprise. The Executive Director of Facility Compliance reports directly to the Chief Compliance and Privacy Officer of Cone Health.

 

This is a hybrid role requiring the leader to be onsite on a weekly bais

 

Responsibilities:

 

Compliance Program Duties

• Maintains and implements a comprehensive facility compliance program which ensures compliance with federal and state billing regulations and the Department of Health and Human Services (HHS) Office of Inspector General's (OIG) Compliance Program Guidance.
• Collaborates with key management associates, key departments, and committees to ensure compliance with applicable laws and regulations and be consistent with the Cone Health’s compliance program.
• Collaborates with Legal Services, the Vice President and Chief Compliance and Privacy Officer to support proper reporting of violations to enforcement agencies as appropriate or required.
• Ensures processes and procedures are in place to maintain consistent facility compliance program application of sanctions for failure to comply with compliance policies and procedures in cooperation with Human Resources and Administration Teams, as applicable.
• Manages HelpLine reports and ensures issues are investigated, addressed, and closed timely.
• Ensures work plan activities are completed appropriately and timely and that any associated Corrective Action Plans (CAP's) are implemented, tracked, and closed timely.
• Presents work plan activity status to the Chief Compliance and Privacy Officer, and appropriate leaders, as well as to the applicable compliance committee.
• Acts as an independent reviewer to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated, and resolved.
• Leads non-compliant issue resolution activities and corrective action follow-up. Any non-compliant issue will be coordinated through the appropriate compliance team for resolution.
• Collaborates with applicable leaders during visits from regulatory agencies, as necessary, to assist in the collection of information and ensure complete and accurate documentation of the proceedings and then report all things back to the compliance team.
• Plans and directs periodic meetings with facility staff to enhance knowledge, address issues, share information to enhance an effective compliance program, and foster the growth of an integrity-based culture.
• Performs the annual risk assessment and developing work plans in coordination and collaboration with department leadership.
• Conducts, supports, and guides preliminary planning and establish direction for audits and investigations.
• Oversees and is responsible for the management of the policies and compliance education and training processes for the facility compliance program.
• Responsible for communication to applicable leaders and staff on regulation, policy, guidance or other areas of focus or changes.
• Manages projects, meet deadlines for completion, and maintain appropriate workflow and workload prioritization.
• Manages staff to perform the required duties of the function in an efficient and effective manner, and in accordance with applicable professional standards.
• Reviews industry, trade and regulatory publications for regulation, policy and enforcement changes, and coordinate compliance and audit activities across Cone Health.
• Performs other related duties and manage other projects incidental to the work described herein.

Qualifications:

 

EDUCATION:

Required
Required: Master's degree in business/health care related field

Preferred
CPA or JD preferred

 

EXPERIENCE:

Required
Required: Minimum 7 years demonstrated experience leading health care regulatory and compliance functions

Preferred
Preferred: Has held compliance leadership role in a mid-sized to large or complex health care setting. Hospital Facility experience important.

 

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

Required
CHC
Preferred
CHRC, CHPS

Job Tags

Full time,

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