Corporate Compliance Officer
Company: UnityPoint Health
Posted on: November 11, 2018
Overview Our team members are the compassionate core of who we are and how we serve. Every day we strive to live out our vision statement of "Best outcome every patient every time" through living out our FOCUS values of Foster Unity, Own the Moment, Champion Excellence, and Seize Opportunities. At UnityPoint Health, we provide care in nine regions throughout Illinois, Iowa, and Wisconsin. As the nation's fourth largest nondenominational health system in America, UnityPoint Health keeps people at the center of all we do. We are looking for dynamic and talented individuals to join our team. You'll find opportunities for every sized dream. The Corporate Compliance Officer (CCO) is primarily responsible for compliance activities and education of MHSC and entities controlled by MHSC. The CCO implements policies, procedures and practices designed to ensure compliance with the requirements set forth in the controlling compliance policies, documents, and applicable laws. The CCO oversees the HIPAA Privacy Officer, the risk management program, event management, patient advocacy, contract management and claims management personnel. The CCO coordinates with internal leadership and corporate counsel on legal matters, internal investigations, and auditing. The CCO directly reports to the President and CEO, and Audit & Compliance Committee of the Board on compliance matters. Responsibilities Develops and Implements plans and programs that support, maintain, and advance compliance at UPH.* Oversees and monitors the implementation of the Corporate Compliance Program for MMCI. Collaborates with the UnityPoint Health Corporate Compliance Officer.* Ensures adherence to all aspects of the system-wide Corporate Compliance Program.* Ensures MMCI operates in compliance with all applicable state and federal laws and compliance guidance; affiliation-wide policies; UPH policies.* Immediately addresses and remedies problematic matters that require a change in policy.* Investigates information or allegations concerning possible unethical or improper business practices and recommends corrective action when necessary.* Coordinates with corporate counsel, outside legal counsel, senior management, and the Audit & Compliance Committee in submitting any reports to government enforcement authorities* Prepares quarterly reports addressed to the Board of Directors and to the Audit & Compliance Committee concerning the compliance activities and actions undertaken during the preceding year, the proposed Compliance Program for the next year, and any recommendations for changes in the Compliance Program.* Provides assessment of existing relationships with physicians, vendors and contractors to determine risk areas as set forth in Compliance Program documents.* Ensures that all employees have a working understanding of the applicable federal and state laws and regulations involving ethical and legal business practices including, without limitation, documentation, coding and billing practices with respect to requests for payments and/or reimbursements from Medicare or any other federally funded health care program, the giving and receiving of remuneration to induce referrals and engagement in certain business affiliations or pricing arrangements that may affect competition* Maintain appropriate documentation of all compliance training programs provided to MMCI employees and physicians in order to assure that orientation training requirements are achieved and training documentation requirements set forth in the Compliance Program are met.* Develops and provides education to leadership and staff pertaining to corporate compliance, risk management, patient privacy, and other relevant topics, as needed.* Serve or liaison to system compliance Chair and regularly attend scheduled meetings with senior management, committees, or others to carry out compliance activities and to resolve compliance issues. Work with Human Resources to ensure that all activities, policies, training adheres to the UnityPoint Health Guide for Employee Conduct, UPH Corporate Compliance Program, and applicable compliance-related policies.* Acts as Chair of the (internal) Multi-disciplinary Audit & Compliance Committee, schedules regular monthly meetings and ensures that the internal committee implements specific tasks set forth in the Compliance Program, is informed of compliance and legal matters, and is able to collaborate in process improvement, risk management, and other efforts to strengthen UPH Compliance Program.* Collaborating with the Chair, facilitate meetings of the Board Audit & Compliance Committee, which meets five (5) times a year to ensure the Board Committee is informed and aware of all compliance and legal matters* Provides guidance and interpretation to the Board of Directors and Leadership, in conjunction with legal counsel, on matters related to the Corporate Compliance Program and UnityPoint Health Guide for Employee Conduct.* Ensures that performance appraisals and job descriptions contain appropriate provisions and requirements for adherence to the UnityPoint Health Guide for Employee Conduct and Corporate Compliance Program.* Ensures that all new employees receive education on compliance matters at New Employee Orientation. Updates annual online educational modules, which all employee must complete, on compliance, risk, and privacy matters* Ensures the screening of all prospective employees, the medical staff, contractors, and board members by requiring the applicant to disclose whether they are Ineligible Persons, and by conducting an online inquiry regarding each applicant through the General Services Administration's List of Parties Excluded from the Federal Programs and the HHS/OIG List of Excluded Individuals/Entities. Collaborates with the UnityPoint Health Audit Department on quarterly checks against the excluded databases for existing employees, medical staff, contractors, and board members.* Coordinates personnel issues with the Human Resources Department to ensure that appropriate disciplinary action has been taken for violations of the written guidelines, and that the Cumulative Sanction Report has been checked with respect to all employees, medical staff and independent contractors.* Ensures that independent contractors and agents who furnish services to MMCI are aware of the Compliance Program including without limitation, the written guidelines with respect to the specific areas of documentation, coding, billing and competitive practices. Independent contractors are to be provided a copy of the UnityPoint Health Guidance for Business Partners. Identifies the functions and activities involving significant regulatory risk to the organization. Ensures adherence and remedy.* Develops compliance workplan.* Plans and oversees regular, periodic audits of "high risk" activities and operations in order to identify and rectify any possible barriers to the efficacy of the Compliance Program.* Collaborates with legal counsel routinely in areas of compliance/legal risk.* Review the reporting of overpayments in concert with legal & Executive Team review. Serve as Director of the Corporate Compliance Department.* As a Director, serve as a member of MMCI Senior Leadership Team.* Serve as direct supervisor for claims, risk, privacy security, patient advocacy personnel employed by the Corporate Compliance Department.* Review and determine the annual budget for the Department* Set annual goals for the department; work with Compliance personnel in establishing their annual goals; ensure annual education is complete* Perform annual evaluations of Compliance personnel; implement corrective action for Compliance personnel, when needed* As directed by Human Resources, ensure Compliance personnel are informed of changes in benefits, terms and conditions of employment, and other HR/personnel matters. Oversees risk management, contract management, claims management, event management and patient advocacy.* Oversee all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization's policies and procedures covering the privacy and security, of and access to, patient health information in compliance with federal and state laws and UPH policies.* Investigate patient privacy and security complaints and reported breaches.* Comply with reporting and notice requirements contained in HIPAA* Develop and provide pro-active and, when necessary, re-active HIPAA/patient privacy education.* Develop and implement annual risk management plan.* Ensure integrity of claims management process.* Chair Grievance Committee.* Ensure resolution to complains and grievances.* Ensure effective incident reporting process. Qualifications Education Bachelors Degree required, Advance degree a plus and/or Juris Doctor (JD). Work Experience At least 5-7 years of experience in/with strong understanding of operations of hospitals and health care systems, directing regulatory monitoring, effectively being able to speak publically with the ability to articulate complex regulatory information in understandable layman's terms, effective interpersonal skills required to interface between medical staff, internal billing and administrative staffs or external vendors and to initiate corrective action as necessary, writing and editing policies and procedures, issue memorandums and compile reports, working knowledge of Medicare billing and coding procedures and State and Federal laws related to false claims, anti-kickback, self-referral and other relevant regulations, developing and implementing compliance strategies and solutions, analyzing and interpreting issues, knowledge of legal documentation procedures and requirements, a demonstrated ability to communicate and interact with officials at all levels of government, knowledge of the range of applicable laws and regulations which impact on all facets of healthcare policy and operations. License and Certification Certificate in Healthcare Compliance (CHC) and/or Certified in Healthcare Privacy Compliance (CHPC), preferred. Required English Skills Advanced reading skills Advanced writing skills Advanced oral skills Other: Advanced public speaking skills, negotiating skills.
Keywords: UnityPoint Health, Peoria , Corporate Compliance Officer, Other , Peoria, Illinois
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