Canton-Potsdam Hospital Director of Corporate Compliance in Potsdam, New York
The Director of Corporate Compliance reports directly to the Chief Compliance Officer. Director reviews, revises, develops, and implements policies and procedures appropriate for managing the compliance function. Director will also plan, direct, and enforce the Corporate Compliance Program. The Director’s overriding mission is to detect and mitigate risk and implement and advance the Program to prevent illegal, unethical, or improper conduct. The Director will have responsibility of ensuring the management of training, audits, investigations, and on-going oversight. Developing and maintaining collaborative relationships with leaders throughout the organization is integral to success.
(%) Plays a key role in establishing a new compliance infrastructure.
(%) Oversees, administers, and monitors the Corporate Compliance Program and revises the Program in light of changes in the organization’s needs, in the laws, and in policies and procedures of the government and private payors.
(%) Identifies compliance risk areas through a risk assessment process and other means, and implements plans to resolve compliance issues.
(%) Provides guidance on payor rules of participation and credentialing.
(%) Maintains a consistent audit schedules and reviews and reports schedule, including randomized and sampled audits of coding and other operational and financial areas.
(%) Monitors audits of billing, coding, reimbursement, and documentation.
(%) Conducts investigations of alleged violations of laws, regulations, policies/ procedures, and Canton-Potsdam Hospital’s Standards of Behavior, Code of Ethics, or Code of Conduct, asserted or potential, on a thorough and timely basis.
(%) Assists in developing and implementing educational and training programs that focus on the elements of the Compliance Program and seeks to ensure that all appropriate employees and management are knowledgeable of and comply with the Coded of Ethics and Code of Conduct as well as applicable federal, state, and local laws and CPH policies.
(%) Serves as a point of contact for compliance issues and in collaboration with the Director of Health Information Management (HIM) for privacy issues.
(%) Receives, investigates, and responds promptly and effectively to compliance related queries.
(%) Oversees operation of the Compliance Hotline.
(%) Consults with Chief Compliance Officer and management on high risk areas and determines action plan.
(%) Ensures the organization is in compliance with applicable accreditation standards (e.g. Det Norske Veritas (DNV), Joint Commission) and state licensing requirements.
(%) Develops operational strategies that ensure compliance with applicable laws and regulations by establishing critical measurements, evaluating trends, resolving problems, and implementing change.
(%) Develops effective compliance communication and ensures training programs on physician practice regulatory matters. Ensures that appropriate Corporate Compliance Program training is conducted.
(%) Identifies potential areas of compliance vulnerability and risk, develops and implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
(%) Provides reports on a regular basis, and as directed or requested, keeps Corporate Compliance Committee and senior management informed of the operation and progress of compliance efforts.
(%) Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the compliance hotline; (b) heightened awareness of Code of Conduct; (c) understanding of new and existing compliance issues and related policies and procedures; and (d) Compliance Newsletter.
(%) Exercises discretion and maintains a high level of confidentiality at all times.
Shift: 7.5 Hour
Required Level: Bachelor's Degree
External Company URL: www.cphospital.org
Licensure / Certification (Text Only): Preferred: Health Care Compliance Certification: CHC, CHPC, CPC or related certification
Required: A minimum of 5 years of experience in a health care organization
Preferred: Experience in building compliance programs, including auditing procedures