Regional Hospital Compliance Officer

JOB SUMMARY:
The Compliance Officer works directly with Medical Center assigned entity leadership teams to prevent and detect potential regulatory compliance problems while partnering with leadership to increase overall efficiency and effectiveness of clinical, financial and administrative operations. The Compliance Officer will be responsible for the oversight of and guidance related to federal and state regulatory and payment requirements and private contracting issues relevant to the prevention and/or detection of fraud, waste and abuse by the assigned entity and its employees and agents.


KEY RESPONSIBILITIES:

• Consultation. Represent the compliance function in advice to Medical Center leadership and process improvement analysis
• Knowledge. Maintain extensive and current knowledge of health care compliance in the areas of Medical Center contracting, processes, systems, documentation and billing
• Policy Development. Coordinate groups and functions to develop and maintain effective and clear policy and procedure applicable throughout the entity assigned
• Internal Controls. Review and recommend controls and processes implemented by employees and systems to verify appropriate operations
• Inquiries. Lead investigations into allegations of errors or process improprieties within the entity
• Liaison. Serve as a liaison between external regulatory auditors and reviewers and the assigned entity
• Collaboration. Facilitate communication between the assigned entity employees and other functions of OCCI, such as education and auditing & monitoring, to minimize regulatory risk and maximize clinical, financial and administrative efficiency

CORE ACCOUNTABILITIES:

• Organizational Impact: Delivers projects/assignments that have a direct impact on goals/objectives of the unit/department that the job is in.
• Problem Solving/ Complexity of work: Conducts extensive analysis of situations or data to resolve numerous, complex issues; may involve the input/work of others.
• Breadth of Knowledge: Has in-depth level of knowledge within a professional area and working knowledge of other areas.
• Team Interaction: May lead mid-sized projects; coaches and guides team members.

CORE CAPABILITIES:

SUPPORTING COLLEAGUES (P4):

• - Develops Self and Others: Invests time, energy and enthusiasm in developing self/others to help improve performance and gain knowledge in new areas.
• - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.
• - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences.

DELIVERING EXCELLENT SERVICES (P4):

• - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.
• - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.
• - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness.

ENSURING HIGH QUALITY (P4):

• - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.
• - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them.
• - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring.

MANAGING RESOURCES EFFECTIVELY (P4):

• - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.
• - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.
• - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities.

FOSTERING INNOVATION (P4):

• - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.
• - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.
• - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.