Director - Healthcare Compliance - Integrity & Compliance

Grant-funded: No. Full-time, exempt position.

About the role

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

Responsibilities

• Provide day-to-day management of assigned staff and direction regarding audits, healthcare rules, laws, and regulations.
• Coordinate and facilitate committee meetings, including compliance subcommittees overseeing compliance of the university health system.
• Stay abreast of federal and state rules, laws, regulations, policies/procedures applicable to healthcare, third-party billing policies/procedures (specifically federal payers), and coding updates.
• Develop, implement, and maintain system-wide programs, policies, and procedures to ensure compliance with federal and state rules, laws, and regulations applicable to healthcare.
• Develop and implement/present training as needed to ensure institutional healthcare compliance, including both group and individual training.
• Investigate/review allegations of compliance plan violations as needed or directed.

The duties listed are general in nature and examples of duties performed; management retains the right to add or change duties at any time.

Requirements

• Bachelor’s degree.
• Five (5) years of compliance experience in a healthcare setting.

Preferred Qualifications

• Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification from the American Health Information Management Association.
• Supervisory experience.

Skills

• Advanced knowledge of medical billing, including 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 applicable to healthcare.
• Knowledge of accounting/business principles.
• Verbal and written communication skills.
• Ability to speak in public settings/forums.
• Analytical and critical thinking skills.
• Ability to work independently and in a group setting.
• Knowledge and skill in utilizing basic business software applications.

Physical and Environmental Demands

• Occasional working hours significantly beyond regularly scheduled hours (up to 20%).
• Occasional travel to offsite locations (up to 20%).
• Occasional activities subject to significant volume changes of a seasonal/clinical nature (up to 20%).
• Frequent work produced subject to precise measures of quantity and quality (21% to 50%).
• Occasional bending (up to 20%).
• Occasional lifting and carrying up to 50 pounds (up to 20%).
• Occasional crouching/stooping (up to 20%).
• Occasional driving (up to 20%).
• Occasional reaching (up to 20%).
• Frequent sitting (21% to 50%).
• Frequent standing (21% to 50%).
• Frequent twisting (21% to 50%).
• Frequent walking (21% to 50%).

Pay

Salary position. FTE: 100%.

Schedule

Full-time, day shift.

Benefits

Benefits eligible.