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Director Of Compliance

Company: Cross Country Healthcare
Location: Oakland
Posted on: June 26, 2022

Job Description:

The Position: The Director of Compliance will lead the Compliance Department working cross functionally ensuring Organization is compliant with regulatory, licensing, and contractual requirements of Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and other regulatory agencies. This requires a broad knowledge and oversight of internal and external provider compliance and program development. This position reports directly to the CEO and CFO.Duties and Responsibilities

  • Oversight of the Compliance Program Manager in the administration of the Compliance Program.
  • Leads Policy Review Committee and oversight of the organizations development and implementation of policies and procedures.
  • Leads Compliance Committee including the development and successful completion of the committee's annual work plan, Risk Assessment, reporting, and other related projects.
  • Draft/negotiate BAAs, data processing agreements and data provisions.
  • Assesses risks, identifies trends, and develops annual compliance work plan.
  • Institutes and maintains an active compliance communication program, including the Compliance Hotline and heightened awareness of the Code of Conduct.
  • Conducts compliance/fraud, waste and abuse investigations as necessary.
  • Oversight and monitors compliance including: Licensing, CAPs, the Fraud, Waste, and Abuse (FWA) program, and Grievance and Appeals.
  • Assures compliance with all State and Federal regulations regarding PACE services.
  • Investigate and document alleged violations of laws, regulations, policies, and procedures
  • Company liaison with CMS, DHCS, and other regulatory agencies regarding regulatory policy.
  • Leads organization in preparation for CMS, DHCS and other regulatory agencies' site visits regarding PACE audits and opening of new site locations.
  • Develops cross-departmental work plans for external regulatory audits. Manages the collection, review, and quality check of deliverables.
  • Coordinates with internal departments in developing corrective action plans in response to audit deficiencies and monitors status.
  • Fosters and maintains collaborative relationships within the leadership and management and with external agencies related to peer review, accreditation, and regulatory requirements.
  • Maintain a current working knowledge of regulations and regulatory changes relevant to CEI and the PACE model.In addition to the Duties and Responsibilities outlined above, this position is expected Perform other duties as assigned in a positive and helpful mannerQualifications
    • Bachelor's degree required; master's degree preferred in Public Health, Nursing, Healthcare Administration or related field strongly preferred.
    • Certification in Healthcare Compliance (CHC) and HIPAA Privacy Certification (CHCP) is a plus
    • 10 years of progressive experience in healthcare compliance.
    • Experience interpreting, implementing and monitoring regulatory requirements and/or guidelines from CMS and DHCS required.
    • Experience working with regulatory agencies.
    • PACE program experience highly desirable.
    • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information
    • Excellent leadership, strategy, management, and organizational skills.
    • Ability to read, analyze, and provide sound interpretation of rules, regulations, and guidelines.

Keywords: Cross Country Healthcare, Oakland , Director Of Compliance, Executive , Oakland, California

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