Senior Director of Compliance

Public Health Management Corporation - Philadelphia, PA3.5

30+ days ago
Reporting to the Chief Operations Officer (COO), the Senior Director of Compliance, serving as the organization’s “Compliance Officer”, is responsible for leading the compliance strategies and activities for PHMC enterprise. The Senior Director of Compliance will ensure alignment with business goals, objectives and by establishing uniform compliance standards across the organization. The Senior Director will work closely with the Senior Director of Quality and Performance Improvement and senior leadership to drive compliance as a core competency and integrate compliance into the business plans in accordance PHMC’s principles, Mission, Vision, and Values. The Senior Director of Compliance will provide leadership, direction and general oversight to the Compliance staff.

Development of compliance policies and procedures, including standards of conduct:

Maintains comprehensive compliance program ensuring adherence to Federal, State, Local and licensing/accreditation requirements. Plan must include measures to prevent, detect and correct program noncompliance for core requirements: Written Policies, Procedures and Standards of Conduct; Compliance Officer, Compliance Committee and High Level Oversight; Effective Training and Education; Effective Lines of Communication; Well Publicized Disciplinary Standards; Effective System for Routine Monitoring and Identification of Compliance Risks; and Procedures and System for Prompt Response to Compliance Issues.
Oversees the review and submission of the Medicaid OIG plan annually to appropriate oversight agencies.
Reviews policies and procedures to support best practice, ensures required review and approval, and that staff are informed and adhere
Develops standards of performance and related metrics and monitoring for the enterprise and specific lines of business.
Oversees and monitors the HIPAA Privacy program. Including Policy and procedures related to 21st Century Cures Act, MACRA, HITECH, FDASIA
Maintains the Compliance Hotline (whistleblower) and directs investigations related to compliance and/or HIPAA Privacy matters, tracks and produces trending reports

Communication and Reporting:
Designs and executes, in partnership with Communications, compliance awareness across the organization, which includes creating communications and training for employees across the enterprise
Develops and enhances uniform reporting templates and works closely with internal stakeholders on preparation of compliance executive management and Board reporting
Provides appropriate training and education to staff within the enterprise
Designs and implements, in coordination with HR and Organizational Development, a compliance training plan, risk area specific training, process for updates, strategy for visual display and reminders.
Advances positive culture and employee buy-in

Internal monitoring and auditing:
Actively collaborates with senior leadership and ensures frequent bidirectional accountability with the legal, quality and financial and human resource departments
Establishes and implements systems for routine monitoring and auditing reasonably designed to identify violations of policies, regulations, Code of Conduct and applicable laws
Implements regular risk assessment processes to identify key areas of compliance risk in close coordination with the legal risk management staff.
Conducts annual reviews of the Compliance Program and reports metrics and data sufficient to evaluate Program effectiveness
In partnership with stakeholders, oversees and monitors the enforcement of compliance obligations and standards through appropriate disciplinary mechanisms.
Oversees incident reporting process, reporting, stratification, trending, and corrective action
Establishes effective means to ensure that appropriate stakeholders and leaders review, evaluate, and act upon information reported
Conducts timely investigations of identified potential compliance issues and consult with legal counsel and others as appropriate

Enforcement of Disciplinary Standards:
In partnership with stakeholders, oversees and monitors the enforcement of compliance obligations and standards through appropriate disciplinary mechanisms.

Knowledge of state and federal laws and regulations, industry guidelines and other requirements relevant to PHMC enterprise compliance needs
Strong interpersonal skills including ability to communicate effectively with people individually and groups; ability to communicate with technical and non-technical colleagues
Strong organizational and analytical skills
Able to prioritize and align the organization against goals and objectives; ensures rigor in operational excellence; and focuses on outcomes with clear measures and metrics.
Ability to build and manage relationships with business partners
High degree of initiative and proactive project management
Ability to work effectively with diverse stakeholders, peers and clients
Ability to motivate staff while holding them accountable for deliverables
Experience with conducting compliance investigations and developing action plans
Excellent Microsoft Office Suite skills particularly Excel

Education and experience:
Bachelor Degree required; advanced degree preferred.
5 years of experience in compliance, auditing, health care management, and/or other relevant field.

Commensurate based on education and experience.

Equal Opportunity Employer:
PHMC recognizes the advantages of a diverse workforce achieved through a commitment to equal employment opportunities.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled