Program Director Medicare Compliance-Health Plan

Johns Hopkins Medicine; Maryland; On-site; USD 104,000 - 181,000; Full time

Job summary

The Johns Hopkins Health System is seeking a Director of Compliance to lead and oversee compliance activities across the affiliate. You will audit processes, interpret results, and guide staff on regulatory requirements for government payers.

Requirements include a Bachelor’s degree in accounting or related field, with a Master’s preferred, and at least ten years in a healthcare setting with leadership experience. Equity and benefits are offered with a competitive salary.

Qualifications

• Requires a Bachelor’s Degree in Accounting, Business Administration, Hospital Administration, or health care related field. Master’s Degree preferred.
• Strong knowledge of federal and state regulations, third-party regulations for reimbursements, and documentation standards.
• Ten years of healthcare leadership experience and project management.

Responsibilities

• Conduct audits and oversee audit results for the affiliate.
• Monitor new rules and regulations and advise relevant staff promptly.
• Provide guidance to ensure compliance with government payer requirements.

Skills

Regulatory compliance

Leadership

Auditing

Data analysis

Communication

Education

Bachelor’s Degree in Accounting/Business/Hospital Admin

Master’s Degree preferred

Tools

Word processing

Database management

Job description

Requisition #:675895 Location:Johns Hopkins Health System, Hanover, MD 21076 Category:Manager/Supervisor Schedule:Day Shift Employment Type:Full Time

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.

Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.