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Job Description Summary:
Work with the Chief Ethics and Compliance Officer to develop, maintain and support the Corporate Ethics and Compliance Program. Have primary responsibility for all compliance documents, including the Code of Conduct and annual Ethics and Compliance Work plan for assigned compliance areas.
Direct, coordinate and perform audits/reviews to prospectively test compliance with established laws, regulations, company policies, and managerial guidelines for assigned areas. Perform sensitive and complex investigations, with the Office
of the General Counsel and other stakeholders as needed.
This position requires strategic thought leadership to communicate and consult
on general compliance requirements and federal/ state privacy regulations/requirements across the system. This role also requires the ability to proactively prevent compliance issues for hospitals, facilities, physicians, non-physician clinicians, and other OhioHealth business units.
Responsibilities And Duties:
1. 30% Develop, maintain, support, and execute the OhioHealth Ethics and Compliance Program, Annual Ethics and Compliance Work pPlan, and Code of Conduct across the system. Responsible for spearheading compliance initiatives and providing compliance direction to the system. Assess progress and report key results and the status of overall compliance initiatives to the Ethics and Compliance Senior Leadership Committee.
2. 30% Provide day-to-day management, planning and supervision of the Ethics and Compliance Department including supervision of all assigned Ethics and Compliance Department associates in accordance with the organization's policies and procedures. Ensure the highest level of department and individual performance through mentoring and development of staff skills and experience, with a particular focus on audit and investigation leadership.
3. 20% Create a working relationship with all OhioHealth associates and physicians which allows for accomplishing the desired goals of the Ethics and Compliance Program on a timely basis. Provide consultative leadership, expertise, guidance and support to OhioHealth and its members as an internal authority on relevant compliance laws and regulations. Develop educational materials and training including ACE, ICE, the Code of Conduct, and resources to educate OhioHealth associates and physicians in compliance matters. Promote an organizational culture of compliance.
4. 10% Maintain a current understanding of state and federal healthcare laws, regulations, and standards, including Medicare, Medicaid, HIPAA, Stark, AKS, and FCA. Maintain an understanding of ICD, CPT coding nomenclatures.
5. 10% Complete special projects, as requested by the Ethics and Compliance Officer and needs of the organization.
As a High Reliability Organization (HRO), responsibilities require focus on safety, quality, and efficiency in performing job duties.
The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time.
Minimum Qualifications:
Master's Degree (Required)CPA - Certified Public Accountant - American Institute of Certified Public Accountants, MBA - MBA - State of Ohio
Additional Job Description:
MINIMUM QUALIFICATIONS
- Master's Degree (e.g., MBA, CPA - Certified Public Accountant or equivalent)
- Field of Study: Administration
Years of experience: 8 to 15
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SPECIALIZED KNOWLEDGE
Licensed CPA, MBA, or related field. One or more of the following certifications may be required depending on the area of specialty:
Certified Professional Coder (CPC) by the American Academy of Professional Coders, Certified Coding Specialist -Physician Base (CCS-P) by the American Health Information Management Association, Certified Fraud Examiner (CFE) by the Association of Certified Fraud Examiners, Certified in Healthcare Compliance (CHC) by the Health Care Compliance Association, Certified Professional Medical Auditor (CPMA) by the American Academy of Professional Coders, Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) by the American Health Information Management Association.
Advanced regulatory knowledge in federal state privacy laws, state and federal healthcare laws, regulations, and standards, including fraud, abuse, and compliance. Knowledge of CPT Coding, ICD-10, Compliance Programs, conducting and overseeing Investigations and Auditing.
Ability to critically analyze, challenge and recommend improvements related to documentation, coding, operational and compliance processes and controls. Outstanding verbal and written communication skills. Advanced a Ability to interact effectively across entities throughout the system, especially with physicians. Able to work independently, as an effective team member, and as a department director and leader in OhioHealth. strong analytical abilities along with demonstrated aptitude for compliance analysis, auditing and attention to detail. Able to identify problems and recommend effective and efficient solutions. Proficiency with personal computers and related software. High degree of credibility, independence, integrity, and confidentiality.
- 10-15 years' experience in a healthcare compliance program or related field;
- 8-10 years managerial Experience in academic and non-academic health systems, health care administration, consulting and or internal auditing.
Experience working in complex healthcare organizations. Extensive experience in federal state privacy.
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DESIRED ATTRIBUTES
Statistics and data analysis, compliance risk assessments and effectiveness reviews. Familiar with Excel and Access and computer systems.
Work Shift:
Day
Scheduled Weekly Hours :
40
Department
Ethics And Compliance Office
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Remote Work Disclaimer:
Positions marked as remote are only eligible for work from Ohio .
