Associate Director, Compliance Initiatives: Lead Investigations

Utmb; Galveston (TX); On-site; USD 120,000 - 180,000; Full time

Job summary

UTMB Health seeks an Associate Director, Compliance Initiatives to lead complex investigations and audits, collaborating with Compliance Attorneys and leadership to research deficiencies, develop recommendations, and ensure timely, accurate information for informed decisions.

The role oversees meetings, committee work, and reporting on audit activity, regulatory changes, and remediation efforts, while guiding staff in applying CMS, HHSC, and payer requirements across the institution.

Qualifications

• Bachelor’s degree in a related field plus seven (7) years of experience in healthcare administration, with emphasis on compliance.
• Preferred: Master’s degree in a related field.
• Certifications: CPC-H, CPMA, CCS-P, CCS, CHC, CFE, EPIC Certification.

Responsibilities

• Investigations/Audits: research deficiencies, conduct investigations, and develop post-review memorandums with guidance for HIPAA, COI, hotlines, billing disputes.
• Compliance Liaison: coordinate with CMSHHSC and other payors; communicate with regulators; provide reports on audit activity and remediation actions.
• General Compliance Activities: stay current with evolving rules; develop training; interpret regulatory requirements for operations.
• Meetings/Committees: chair and support committees; prepare reports, agendas, and action item follow-ups.
• Research and Reporting: perform regulatory research; prepare presentations for leadership; compile quarterly EBCC reports and conduct ad hoc analyses.
• Software/Third-Party Vendors/Invoicing: act as system administrator for auditing software; review invoices and assist budgeting; support special projects and internal controls.

Skills

Attention to Detail

Communication Skills

Critical Thinking

MS Office Suite

Education

Bachelor’s degree in a related field

7 years of experience in healthcare administration with compliance

Master’s degree in related field (preferred)

CPC-H (preferred)

CPMA (preferred)

CCS-P (preferred)

CCS (preferred)

CHC (preferred)

CFE (preferred)

EPIC Certification (preferred)

Tools

EPIC

Slicer Dicer

MD Audit

Job description

UTMB Health seeks an Associate Director, Compliance Initiatives to lead complex investigations and audits, collaborating with Compliance Attorneys and leadership to research deficiencies, develop recommendations, and ensure timely, accurate information for informed decisions.

The role oversees meetings, committee work, and reporting on audit activity, regulatory changes, and remediation efforts, while guiding staff in applying CMS, HHSC, and payer requirements across the institution.