Avp Investigations - Remote | Wfh

We are excited to offer an opportunity for an AVP of Investigations at our dynamic organization, LifePoint Health. As a leader in community-based care, we are driven by a mission of Making Communities Healthier. With a diverse healthcare delivery network spanning 29 states and a commitment to meaningful and satisfying careers, we strive to create a work environment where employees thrive and make a real difference in communities across the country.
Summary
As the AVP of Investigations, you will play a crucial role in the operation and management of our Company Investigations program. You will ensure the quality of our internal investigation program, overseeing an effective and consistent approach to reporting/intake, triage, investigation, corrective action recommendations, and documentation of each step in the process. Collaborating with various teams, including Legal, Human Resources, Risk, Privacy, and Security, you will investigate and support investigations undertaken by different departments, aligning efforts to prevent, detect, and correct non-compliance. Your role will also involve promoting an environment that encourages information sharing, collaboration, and process improvement to ensure effectiveness, efficiency, and service excellence across multiple teams.
Essential Functions
In this role, you will:
Continuously improve internal investigations protocols and coordinate with other functions conducting investigations, such as Human Resources, Legal, Risk, Privacy, and Security.
Investigate, analyze, and apply judgment to complex fact patterns, including those requiring an understanding of federal healthcare program requirements, fraud and abuse laws, and enforcement policies.
Supervise, support, and assure the quality, thoroughness, and timely completion of investigations led by members of the Investigations team, Business Integrity Partner team, Compliance Monitoring and Regulatory Team, as well as market- and facility-level Ethics and Compliance Officers.
Participate in and lead the development of corrective action recommendations when compliance failures are identified.
Implement a framework to ensure consistent corrective action recommendations across the enterprise.
Ensure all investigations, investigatory findings, and recommendations for corrective action are appropriately documented.
Produce and analyze reports of investigations to identify and highlight trends or systematic concerns.
Participate in or otherwise support internal investigations conducted by other functional areas, including Human Resources, Legal, Risk, Privacy, and Security.
Regularly and reliably attend work.
Perform other duties as assigned.
Access and/or work with sensitive and/or confidential information.
Exhibit a comprehensive understanding of healthcare regulatory and compliance, such as HIPAA, and demonstrate skills in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.
Supervisory Responsibilities
You will be responsible for supervising team member(s) within the investigation team, and will also have the ability to lead effective team initiatives around key objectives, motivating team members to achieve objectives, providing clear direction and support, and working well in a collaborative team environment.
Knowledge, Skills, And Abilities
The requirements listed below are representative of the knowledge, skills, and/or abilities required for this role:
Moderate computer skills, including frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc. Ability to create, maintain, and incorporate simple functions into documents, spreadsheets, databases, and presentations to support business objectives.
Complex communication skills, including the ability to frequently communicate complex information and interact with management. Ability to present, resolve, and address delicate situations, as well as motivate and persuade others.
Ability to analyze and interpret varied and complex business problems, using knowledge, skills, general precedents, and practices to solve them.
Impact on department-specific decisions, contributing to business and operational decisions that affect the department.
Moderate independent judgement, setting personal goals and determining how to achieve results with few or no guidelines to follow, with broad guidance and overall direction from supervisor/manager.