Head of Compliance Investigations and Strategy

The University of Texas Medical Branch; Galveston (TX); On-site; USD 95,000 - 135,000; Full time

Job summary

The University of Texas Medical Branch (UTMB Health) seeks an Associate Director of Institutional Compliance to lead resolution of complex compliance issues, conduct thorough analysis, research, documentation and reporting, and collaborate with stakeholders to provide accurate information for timely, informed decisions.

Responsibilities include investigations/audits, regulatory liaison with CMS, HHSC and other bodies, development of auditing workflows, and strategic recommendations for

Qualifications

• Bachelor’s degree in a related field and 7 years of healthcare administration experience.
• Experience in compliance functions within a healthcare setting.
• Knowledge of hospital billing, auditing, and reporting systems such as EPIC, Slicer Dicer and/or MD Audit.

Responsibilities

• Research deficiencies, conduct investigations, and prepare post-review memorandums with guidance and recommendations.
• Coordinate external reviews and audits with regulators or consulting firms; update tracking databases.
• Develop auditing workflows by payor and manage records requests and appeals for various bodies (Medicare, Medicaid, RACs, OIG, etc.).
• Provide reports to executive leadership on audit activity, trends, financial exposure, and remediation actions.
• Lead committees (Audit Request and Appeals, Compliance Oversight) and track action items to drive compliance initiatives.
• Perform specialized research across regulatory billing and compliance issues using EPIC and related systems.
• Prepare letters to external agencies and quarterly EBCC reports with trends and statistical relevance.

Skills

Billing systems

Attention to detail

Communication

Critical thinking

MS Office

Education

Bachelor's degree in a related field

7 years healthcare administration experience

Tools

EPIC

Slicer Dicer

MD Audit

Job description

The University of Texas Medical Branch (UTMB Health) seeks an Associate Director of Institutional Compliance to lead resolution of complex compliance issues, conduct thorough analysis, research, documentation and reporting, and collaborate with stakeholders to provide accurate information for timely, informed decisions.

Responsibilities include investigations/audits, regulatory liaison with CMS, HHSC and other bodies, development of auditing workflows, and strategic recommendations for