Director Of Compliance
Company: Cross Country Healthcare
Posted on: June 26, 2022
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
- 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
- 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
- Oversight and monitors compliance including: Licensing, CAPs,
the Fraud, Waste, and Abuse (FWA) program, and Grievance and
- 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
- Coordinates with internal departments in developing corrective
action plans in response to audit deficiencies and monitors
- 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
- Bachelor's degree required; master's degree preferred in Public
Health, Nursing, Healthcare Administration or related field
- Certification in Healthcare Compliance (CHC) and HIPAA Privacy
Certification (CHCP) is a plus
- 10 years of progressive experience in healthcare
- 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
- Excellent leadership, strategy, management, and organizational
- 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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