Eve Crane & Associates Inc.©

Managed Health Care Recruiters

Example job description


     

 Job Title:  Vice President/Corporate Compliance
                
 
 Full
 Page 1 of 3
 
 EX
 Dept: Corporate Compliance
 
 Step:   SS
 Reports to: CEO
 President/CEO Signature:
 
       Human Resources Signature:
Role:
The Vice President/ Corporate Compliance (VP/CC) is the Chief Compliance Officer for the Corporation and its subsidiaries. The Vice President is responsible for advising and making recommendations to the President/CEO and the Board of Directors about status of quality, safety and compliance with federal, state and local regulations.  S/he is responsible for the overall effectiveness of the Corporate Compliance Program and serves as the primary corporate resource for Medicare/Medicaid reimbursement information. The Vice President promotes awareness and understanding of ethical and moral principles consistent with the mission, vision, and values of the organization and those required by law.  The VP/CC has the authority to meet the responsibilities of the position and has direct access to legal counsel, the Hospice governing body and CEO/President.  The Vice President is also responsible for overseeing the functions of Performance Improvement, Employee Health and Safety, Infection Control and Health Information Management (Medical Records).
 Qualifications:
•      Master's Degree in healthcare, business or law
•      10 years experience in the compliance field
•       5 years management experience at an executive level
•      Certified Compliance Officer
•      Risk Manager a plus
•      Ability to manage and develop staff
•      Demonstrated commitment to working as part of a team
•      Broad knowledge of the Medicare program, the managed care industry, Sarbanes Oxley, and other    
        pertinent regulations and legislation.
•      Experience in safety and disaster management, medical-legal issues; performance improvement
       methodologies and statistical tools.
•      Strong verbal and written communication, problem solving, change management, and diplomacy skills.
•      Computer skills: windows based applications, spreadsheets, presentation software
•      Confidential and professional in manner and action
 Competencies:
•       Satisfactorily complete competency requirements for this position.
 General Responsibilities:
•       Represent the organization professionally through care delivered and/or services provided to all clients.
•       Comply with all state, federal and local government regulations; maintain a strong position against fraud and
        abuse.      
•       Comply with all policies, procedures and standard practices.
•       Observe all health, safety and security practices.
•       Maintain the confidentiality of patients, families, colleagues and other sensitive situations.
•       Use resources in a fiscally responsible manner.
•       Promote the organization through participation in community and professional organizations.
•       Participate proactively in improving performance at the organizational, departmental and individual levels.
•       Improve own professional knowledge and skill level.
•       Advance electronic media skills.
•       Support the organization’s research and educational activities.
•       Share expertise with co-workers both formally and informally.
 Leadership Success Factors:
•      Communication.  Express thoughts and ideas clearly.  Adapt communication style to fit audience.
•      Initiative.  Originate action to achieve goals.
•      Management Identification.  Identify with the problems and responsibilities of management.
•      Judgment.  Make realistic decisions in consideration of organizational resources.
           
•      Planning, Organizing and Controlling.  Establish course of action for self and others to accomplish a specific goal;         plan proper assignments of personnel and appropriate allocation of resources. Monitor results.
•      Leadership.  Use appropriate interpersonal styles and methods in guiding others toward task accomplishment.
•      Work Standards.  Set high goals or standards of performance for self and others.  Compel others to perform.
•      Tolerance for Stress. Maintain stability of performance under pressure and/or opposition.
•      Innovativeness.  Generate and/or recognize imaginative, creative solutions in work related situations.
•      Delegation.  Allocate decision making and other responsibilities effectively and appropriately.
•      Staff Development.  Develop the skills & competencies of subordinates.
•      Organizational Sensitivity.  Perceive impact and implications of decisions on components of the organization.
•      Ethics. Model highest standards of conduct and ethical behavior.
•      Regulatory Compliance: Educate and monitor staff regarding their own and the organization's responsibilities
        for regulatory compliance.
 Job Responsibilities:
Administration                                                              
•      Responsible for the leadership, recruitment and retention of Compliance, Performance Improvement, Health &
       Safety, and Health Information Services staff.
•     Conduct timely performance evaluations.
•     Ensure staff attendance at requisite education programs.  
•     Lead the strategic planning and implementation process in all areas of responsibility.
•     Develop policies and procedures for all areas of responsibility.
•     Participate in committees and projects as required.
•     Maintain system of reporting to the governing board, CEO and Corporate Compliance Committee.
•     Coordinate personnel issues with Human Resources.            
•     Ensure independent contractors and agents are aware of requirements of billing, marketing etc.  Assist    
      financial management in coordinating internal annual/periodic departmental reviews.
•     Review contracts that may contain referral and payment issues which might violate anti-kickback statute or
      physician self-referral prohibition or other regulatory requirements.
•     Direct processes for medical record form’s approval and administrative policy and procedure review.
 Budget Development and Control
•    Develop/oversee the development of departmental budgets
•    Monitor and control budgets to ensure all guidelines are met and cost effectiveness is maintained.
 Corporate Compliance
•   Develop and implement a system-wide program to ensure compliance with applicable federal and state laws and
     regulations.  Periodically revise program to reflect changes in organizational need, governmental policies &
     procedures, and third party payers. 
•   Direct system-wide audits to investigate and monitor organizational regulatory compliance.
•   Develop policies and procedures for the general operation of the Compliance Program and related activities to    
    reduce vulnerability to misconduct.
•   Maintain current AHCA, CLIA, Biomedical and Occupational licenses.  
•   Chair the Corporate Compliance Committee.
•   Review complaints, concerns, questions, or corrective actions relative to compliance issues in all departments, or
    with regulatory agencies. 
•   Make recommendations for the reporting of suspected fraud and other improprieties. 
•   Manage the Compliance Hotlines and responds to reports.
•   Collaborate with other departments, General Counsel, fiscal intermediaries, state and federal regulatory agencies
     to address issues or concerns.
•    Keep abreast of changes by regulatory agencies and community/national standards as they relate to Hospice and
     communicate them to the management team. 
 Risk Management
•    Implement and maintain a proactive Risk Management Program which identifies, implements and recommends
     actions to reduce potential risks and promote the quality of hospice care and services.
•    Coordinate depositions from staff with legal counsel.
•    Interface with legal counsel appointed by the organization’s liability carriers.
•    Advise Interdisciplinary Team members on risk issues.
 Staff Development/Education                             
•    Provide or coordinate orientation, education and training relevant to regulatory compliance, safety, disaster, infection
     control, accreditation standards, HIPAA standards, and Performance Improvement.
•    Provide for Performance Improvement education to all levels of staff. 
•    Identify educational opportunities for department staff to increase expertise and value to the organization.
•    Provide regular performance feedback and guidance to department staff.
 Professional Self-Development               
•    Enhance professional expertise, management competency and leadership skills through education and training.
 Other
•   Coordinate JCAHO, AHCA and Medicare Surveys.
•   Perform other duties as requested by President/CEO.
            



Eve Crane & Associates Inc.
Managed Care Recruiters

561-439-3234
EMAIL

 
 


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