Compliance Officer

CMU Health; Saginaw (MI); Sur place; USD 90 000 - 130 000; Plein temps

Résumé du poste

CMU Health is seeking a Compliance Officer in a full-time role within the Administration department. You will administer the Corporate Compliance Program, lead the Work Plan, and coordinate audits, investigations, and education to promote ethical conduct across the organization.

You will partner with leadership, legal, Finance, Revenue Cycle, HR, Medical Education and clinical departments to mitigate risk and ensure regulatory alignment. AA/EO institution with equal opportunity.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 3–5 years of healthcare compliance or related experience.
• Knowledge of healthcare compliance principles and federal program requirements.
• Experience with audits, investigations, risk assessments or monitoring.
• Experience in physician practice or academic medical organizations preferred.

Responsabilités

• Administer, maintain and improve CMEP Corporate Compliance Program.
• Develop and implement annual Compliance Work Plan and risk assessment.
• Chair CMEP Compliance Committee and coordinate activities.
• Provide compliance reporting to Chief Medical Officer and leadership.
• Maintain compliance policies and educate staff and providers.
• Promote safe mechanisms to raise concerns without retaliation.
• Coordinate investigations of reported compliance concerns.
• Collaborate with legal counsel on matters needing privilege.
• Coordinate corrective action and monitoring for substantiated concerns.
• Audit and monitor compliance risk areas and billing practices.
• Monitor regulatory developments and communicate changes.

Formation

Bachelor's degree in healthcare administration, Business Administration, Finance, Compliance or related field, or an equivalent combination of education and relevant experience.

Experience in healthcare compliance, revenue integrity, professional billing or healthcare administration.

Working knowledge of healthcare compliance principles and federal program requirements

Audits, investigations, risk assessments or compliance monitoring experience

Experience in physician practice or academic medical organization environment preferred

Description du poste

Compliance Officer (Full Time)
Department: Administration

The Compliance Officer is responsible for administering and continuously improving the organization's Corporate Compliance Program and promoting an organizational culture of ethical conduct, accountability, and compliance.

The position develops and implements the annual Compliance Work Plan and organizational compliance risk assessment; coordinates compliance education, monitoring and auditing; evaluates and responds to reported compliance concerns; and works collaboratively with leadership, legal counsel, Finance, Revenue Cycle, Human Resources, Medical Education, and clinical departments to identify and mitigate organizational risk.

The Compliance Officer serves as a resource to leadership, physicians, residents, advanced practice providers, faculty, and staff regarding applicable federal and state healthcare requirements and organizational compliance expectations.

What You'll Do

• Administer, maintain and continuously improve the CMEP Corporate Compliance Program consistent with applicable federal and state requirements and relevant governmental guidance.
• Develop and implement the annual Compliance Work Plan and organizational compliance risk assessment.
• Chair and coordinate the CMEP Compliance Committee, including development of agendas, documentation of activities and follow-up on identified compliance matters.
• Provide appropriate compliance reporting to the Chief Medical Officer, executive leadership and Board.
• Maintain and periodically evaluate compliance-related policies and procedures.
• Develop and coordinate compliance education for employees, physicians, faculty, residents and other applicable workforce members.
• Promote accessible mechanisms for employees and providers to raise compliance concerns without fear of retaliation.
• Receive, evaluate, document and coordinate investigation of reported or suspected compliance concerns.
• Work collaboratively with legal counsel when matters require legal review or attorney-client privilege.
• Coordinate appropriate corrective action, follow-up and monitoring when compliance concerns are substantiated.
• Conduct or coordinate periodic auditing and monitoring of identified areas of compliance risk.
• Monitor professional billing, coding, documentation and related revenue-cycle practices for compliance with applicable requirements.
• Partner with Revenue Cycle and Finance to identify documentation, charge capture, coding, billing or collection trends presenting compliance or revenue-integrity risk.
• Monitor applicable regulatory developments and communicate material changes to appropriate organizational stakeholders.
• Support organizational compliance with applicable fraud, waste and abuse requirements and federal healthcare program requirements.
• Coordinate exclusion screening and other compliance monitoring processes, as applicable.
• Assist leadership in identifying emerging compliance risks associated with new programs, affiliations, contracts or operational changes.
• Maintain appropriate compliance documentation and records.
• Prepare compliance reports and metrics for leadership and governance review.
• Serve as a neutral and accessible organizational compliance resource.
• Perform other related duties as assigned.

What You'll Bring

• Bachelor's degree in healthcare administration, Business Administration, Finance, Compliance or related field, or an equivalent combination of education and relevant experience.
• Minimum three to five years of progressively responsible experience in healthcare compliance, revenue integrity, professional billing, healthcare administration or a related field preferred.
• Working knowledge of healthcare compliance principles, professional billing/documentation requirements and federal healthcare program requirements.
• Experience conducting or coordinating audits, investigations, risk assessments or compliance monitoring preferred.
• Experience within a physician practice, academic medical organization or medical education environment preferred.

CMU is an AA/EO institution, providing equal opportunity to all persons, including minorities, females, veterans, and individuals with disabilities.