Program Director Medicare Compliance-Health Plan

Johns Hopkins Medicine; Hanover (MD); On-site; USD 104,000 - 181,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Life insurance

Disability insurance

403(b) with employer match

Tuition assistance

Wellness programs

Job summary

Johns Hopkins Medicine is seeking a Director of Compliance to assist the Chief Compliance Officer, oversee audits, and interpret results while monitoring federal and state regulations across the health system. The role requires a Bachelor’s in accounting, business, hospital administration or related field, with a Master’s preferred, and a minimum of ten years in healthcare compliance leadership.

You will coordinate with revenue cycle management, internal audit, coding, billing QA and risk

Qualifications

• Knowledge of federal and state regulations and third-party reimbursement policies.
• Ability to monitor changes in healthcare laws impacting operations.
• Strong leadership, time management, and organizational skills.
• Excellent communication with medical and administrative staff at all levels.
• Strong analytical skills to interpret regulatory reports and recommend actions.
• Excellent business writing and documentation skills.
• Proficient computer skills including word processing and databases.

Skills

Regulatory compliance

Leadership

Analytical ability

Verbal & written communication

Education

Bachelor’s degree in Accounting or healthcare field

Master’s degree preferred

Tools

Word processing

Database management

Job description

The Director of Compliance is responsible for assisting the Chief Compliance Officer/Deputy Chief Compliance Officer is an individual who has a thorough understanding of products and services provided by the affiliate and all associated requirements for billing the products and services to governmental payers. The position has primary responsibility of conducting audits and overseeing, and interpreting audit results for the affiliate. The Director is also responsible for monitoring new rules and regulations and advising in a timely fashion relevant staff. This position reports to the Johns Hopkins Health System Chief Compliance Officer and supports the Johns Hopkins Health Plan.

The Johns Hopkins Health System Corporation is a not-for-profit organization dedicated to providing the highest quality of care in the treatment and prevention of human illness. JHHS is an academically based health system consisting of: The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Johns Hopkins Howard County Medical Center, Suburban Hospital, Sibley Memorial Hospital, The Johns Hopkins All Children’s Health System, Johns Hopkins Community Physicians, The Johns Hopkins Medical Services Corporation and Johns Hopkins Medical Management Corporation.

QUALIFICATIONS

Education:

Requires a Bachelor’s Degree in Accounting, Business Administration, Hospital Administration, Clinical or health care related field. Master’s Degree preferred.

Knowledge, Skills, and Abilities:

• Requires excellent knowledge of JHHS products and services, and an understanding of federal and state regulations, applicable government agency compliance policy and procedures, and third-party regulations for reimbursements of services, including medical record, coding, and documentation standards and guidelines.
• Experience monitoring state and federal laws and regulations for changes that will impact the operations of the organization.
• Requires leadership, time management, organizational skills, and the ability to be self-directed and confident working in relatively unstructured situations.
• Strong leadership/managerial skills and ability to motivate/coach other staff.
• Requires excellent verbal, written, and interpersonal communication skills for interaction with medical and administrative personnel, at all levels of the organization.
• Requires excellent analytical skills to analyze regulatory requirements, medical records, claims data, and interpret reports, and provide recommendations based on analysis.
• Requires excellent technical and business writing skills.
• Requires excellent computer experience with word processing and database management skills.

Required Licensure, Certification, On-going Training:

• CPC, CHC, CCS, RHIA or RHIT preferred.

Work Experience:

• A minimum of ten (10) years of related healthcare setting experience, with leadership experience in mid to upper-level management.
• Demonstrated experience with a variety of services provided in an academic health system setting preferred.
• Experience in designing, implementing and managing a project.
• Experience working in a collaborative environment with proven and documented initiatives to enhance risk mitigation in target areas, including coordination with the offices of revenue cycle management, internal audit, coding, billing quality assurance, and risk management.

What We Offer:

You can become a part of our diverse healthcare leadership team and enjoy extensive benefits with a variety of opportunities for personal and professional growth. From academic medical centers to local community hospitals, from downtown to the suburbs, Johns Hopkins Medicine has a work environment that will fit your personality and career goals.

Comprehensive benefits including medical, dental, and vision insurance; generous paid time off; life and long-term disability coverage; 403(b) retirement plan with employer match; tuition assistance for employees and dependents; and wellness programs just to name a few.

Salary Range:

Minimum 103,730.00/annually - Maximum 181,334.00/annually. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.