Manager Compliance - Physicians Medical Center

Responsibilities

• Overseeing and monitoring the implementation of the Program.
• Serving as an internal resource with whom stakeholders may consult.
• Reporting regularly to the Company’s Board of Managers and SCA Health’s Compliance department on the status of the Program and any material compliance events.
• Developing a budget for compliance-related activities.
• Maintaining, along with the Chief Human Resources Officer, the SCA Health Code of Conduct that provides current guidance to relevant stakeholders about the Company’s expectations regarding compliance and ethical business practices.
• Developing and updating, as appropriate, SCA Health compliance policies and procedures.
• Developing, where necessary, specific Company-related training and implementing SCA Health’s Compliance training.
• Ensuring SCA Health compliance-related materials are made available to relevant stakeholders.
• Conducting or, as appropriate, overseeing internal investigations involving potential or actual noncompliance with legal requirements or the Company’s policies, procedures, or expectations of compliant and ethical workplace behavior and reporting the findings and recommendations to SCA Health Compliance and management.
• Maintaining a log of compliance internal investigations that documents the identification, investigation, and resolution of such matters.
• Ensuring the Company’s agreements with related parties and referral sources (including leases and services agreements) are reviewed on an annual basis to confirm fair market value and commercial reasonableness.
• Following up on any outstanding excluded party reporting items.
• Assisting SCA Health Compliance and any outside vendor in completing coding audits, up to and including working through corrective action plans as outlined by SCA Health Compliance and SCA Health Coding, and assisting with any transition to SCA Health Coding platform.
• Interacting with legal counsel, government agencies, and other external parties on matters relating to compliance with SCA Health Compliance’s guidance; and
• Performing other functions as specified by SCA Health Compliance throughout the Program’s policies and as assigned.

Qualifications

• Education and Experience: College degree or equivalent experience required; compliance-related education or certification preferred.
• Experience: Experience in health care compliance, audit, quality assurance, or other similar field.
• Knowledge, Skills, And Abilities: Demonstrated knowledge of government and private payer reimbursement rules and policies, as well as fraud and abuse laws, including the Stark Law and compliance with the whole hospital exception to Stark Law.
• Interpersonal and Communication Skills: Strong interpersonal and communication skills, including the ability to motivate personnel.
• Writing and Presentation Skills: Strong writing and presentation skills, clear, concise, and persuasive.
• Ethical Standards: Unwavering personal and organizational ethical standards.
• Deadlines and Detail: Strong orientation to deadlines and detail.
• Decisiveness and Judgment: Decisive and capable of exercising good judgment under pressure.
• Workload Management: Ability to manage a diverse and demanding workload.
• Technical Skills: Word processing PC skills, knowledge of PowerPoint, and Excel.
• Personal Presence: Personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of the organization.

Pay

USD $110,000.00/Yr. USD $160,000.00/Yr.