Compliance Program Manager

Qualifications

• Education: Doctor of Jurisprudence (JD), Master of Healthcare Administration (MHA), Master of Business Administration (MBA) or Master of Jurisprudence (MJur); if JD, must be in good standing with State Bar Assoc.
• Experience: Five years' experience working in health care regulatory compliance
• Licenses and Certifications: Required - Two of the following certifications required: CHC, CHRC, CHPC, CHC-F, CCEP, RHIA, CMPA, CPCO, or CPHRM within 1 year

Essential Functions

• People: Manages relationships within the department and across the Houston Methodist system to ensure customer requirements are known and met, and to ensure smooth implementation of program objectives.
• Service: Designs, develops, implements, and maintains a minimum of one or more elements of an effective compliance program. Provides consultative services as needed to drive the program to successful outcomes. Leads system-wide development, promotion, and maintenance of assigned components of the Business Practices Program.
• Quality/Safety: Validates program and project prioritization with senior management. Ensures adherence to standards and compliance with regulations. Identifies the need for and leads efforts to write policies, protocols and procedures to address system-wide business practices issues including drafting and working with others to adopt. Manages system-wide special projects that require research, data collection, analysis of processes and evaluation of applicable regulations and guidelines.
• Finance: Accountable for adhering to approved budget and program/project timeframes. Utilizes resources effectively and efficiently, demonstrating responsible financial stewardship.
• Growth/Innovation: Collaborates and networks to develop and seek out best practices. Independently seeks opportunities to identify and streamline inefficiencies. Builds strategies for growth, development, and promotion of the program and oneself.

Supplemental Requirements

• Work Attire: Business professional
• On Call*: Yes
• May Require Travel: Yes

About the Role

Manages relationships within the department and across the Houston Methodist system to ensure customer requirements are known and met, and to ensure smooth implementation of program objectives.

Effectively communicates program information and progress to stakeholders; manages all communication channels with other departments and groups.

Maintains high visibility of program and interactions with the appropriate executives and stakeholders and may supervise law student interns.

Designs, develops, implements, and maintains a minimum of one or more elements of an effective compliance program. Provides consultative services as needed to drive the program to successful outcomes. Leads system-wide development, promotion, and maintenance of assigned components of the Business Practices Program.

Designs, delivers and assesses educational materials for use in a variety of training modalities for all individuals at all levels of the organization, including physicians, Department Chairs, and executives. Provides detailed analysis and reporting as necessary to senior management. Develops materials & presentations for various stakeholders.

Validates program and project prioritization with senior management.

Ensures adherence to standards and compliance with regulations. Identifies the need for and leads efforts to write policies, protocols and procedures to address system-wide business practices issues including drafting and working with others to adopt. Manages system-wide special projects that require research, data collection, analysis of processes and evaluation of applicable regulations and guidelines.

Initiates quality improvement activities, including the use of benchmarking and sharing of best practices.

Independently conducts complex and/or sensitive privacy and compliance incident investigations, designing and implementing System-wide corrective action plans to address areas of non-compliance to include highly complex monitoring and assessment of plan reports.

Conducts regulatory compliance research and analysis of highly technical billing compliance risks, including fraud, waste, and abuse risk areas, and identifies the need for and leads efforts to mitigate and remediate areas of concern.

Accountable for adhering to approved budget and program/project timeframes. Utilizes resources effectively and efficiently, demonstrating responsible financial stewardship.

Ensures progress against annual goals for the program and program objectives.

Collaborates and networks to develop and seek out best practices.

Independently seeks opportunities to identify and streamline inefficiencies.

Buils strategies for growth, development, and promotion of the program and oneself.

Company Profile

Houston Methodist is one of the nation’s leading health systems and academic medical centers. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area. Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. Come lead with us!

Houston Methodist is an Equal Opportunity Employer.