Compliance Consultant Jobs

The Compliance Officer Consultant is responsible for developing a comprehensive compliance program which, through its policies and procedures, monitoring and auditing functions, and training and education, is designed to prevent, detect and mitigate regulatory risk for the company. The Compliance Officer Consultant will ensure the compliance program promotes an organizational culture that fosters ethical business behavior and ensures compliance with all Federal and State healthcare laws and regulatory requirements. The Compliance Officer Consultant will regularly report to the Board of Directors, Chief Executive Officer, and other Executive Leadership on the status of the compliance program, including tactics for preventing regulatory risks, detecting regulatory risks, and mitigation strategies. These duties outlined as The Compliance Officer Consultant are required for the position at Ronan Healthcare Consultants where you will be acting as an Interim Compliance Officer for multiple healthcare companies across various specialties.

Responsibilities and Duties (Acting as Interim Compliance Officer):

• Report to the Board of Directors on compliance-related matters, as needed;
• Conduct periodic reviews of the compliance program and make revisions in consideration of changes in the organization’s needs and/or the statutes, rules, regulations, and requirements of federal and state health care programs;
• Oversee monitoring and auditing processes to evaluate ongoing compliance of key compliance risks as identified through the risk assessment process, government enforcement efforts, and/or reported compliance concerns;
• Act as Chair of the company Compliance Committee which provides an opportunity to report to the Chief Executive Officer and other Executive Leadership regularly on compliance-related matters;
• Protect the confidentiality of employees who make inquiries or report violations;
• Drive performance management through mentoring.
• Maintain current working knowledge of federal and state regulations and policies as they affect the company through routine review of various CMS manuals, Federal Register notices, applicable government and/or industry-related internet information sites, and state Medicaid manuals;
• Communicate detected regulatory risks to organizational leadership and pertinent operational employees and provide additional training and education and/or disciplinary action as needed;
• Oversee investigations of reported or identified compliance matters received and advise on appropriate corrective actions;
• Implement and monitor the Compliance Program;
• Act as a key negotiator in payor disputes;
• Attend leadership meetings to establish awareness of the compliance program;
• Develop and implement annual compliance risk assessment and work plan;
• Responsible for hiring, training, development, and performance management of the compliance team;
• Develop and maintain a positive rapport with payors, CMS, and other applicable federal/state government agencies;
• Create employee awareness of the Compliance Program. Emphasize the employee’s responsibility to be knowledgeable of and comply with applicable federal and state healthcare laws;
• Create/review/revise compliance policies and procedures, as needed. Ensure new and updated compliance policies and procedures are communicated to organizational leadership and employees;
• Oversee corrective action plans developed as a result of a reported or identified compliance matter to ensure appropriate follow-through;
• Responsible for leading and supporting the compliance team through performance evaluations and counseling and/or provision of disciplinary actions, if necessary; and
• Provide training and education and/or develop regular communication on a variety of compliance related topics including but not limited to, Fraud, Waste and Abuse Laws, Anti-Kickback Statute, False Claims Act, HIPAA, etc. Ensure organizational leadership and employees are provided with the most up to date information at the time laws regarding compliance-related topics are updated;
• Maintain a system for reporting potential compliance concerns, including the creation of a compliance helpline for anonymous reports or inquiries from employees;

Minimum Qualifications:

Education/Licensing/Certification:

• Bachelor’s degree in healthcare, business, or organizational related field or comparable corporate experience,
• Certification in Healthcare Compliance and Privacy preferred.
• Master’s Degree in hospital or business administration (MBA or MPH), Juris Doctorate (JD) or related field, preferred, and

Experience:

• Five or more years of experience specific to healthcare specialties, including or a combination of Physician Practice Management, Home Health, Hospice, or Behavioral Health.
• Five or more years of experience specific to a healthcare compliance and leadership position is required.

Knowledge and Skills:

• Experience establishing relationships with organizational leaders, board members, staff, and other healthcare industry leaders.
• Excellent interviewing, negotiating, and interpersonal skills.
• Ability to manage responses to government inquiries, including external Medicare Administrative Contractor audits, federal investigations, and direct outside counsel with respect to criminal and civil litigation.
• Thorough familiarity with relevant laws and regulations, including but not limited to: the Anti-Kickback Statute, the False Claims Act, Stark Law, EMTALA, Civil Monetary Penalties Law, and Health Insurance Portability and Accountability Act (HIPAA).
• Ability to deal effectively at all levels of the organization in ways that enhance understanding, respect, cooperation, and problem-solving.
• Strong verbal and written communication skills.
• Thorough understanding of the regulatory environment of healthcare, ethics, pertinent legislation, OIG, OCR, and other regulatory agency processes.