Delphi Health Group

  • Director of Compliance

    Job Locations US-FL-Ft. Lauderdale
    Posted Date 3 months ago(2/28/2018 3:17 PM)
    ID
    2018-1234
    # of Openings
    1
    Category
    Other
  • Overview

    General Purpose of the Position

     

    • The Director of Compliance monitors and reports results of the compliance and ethics efforts of the company and provides guidance to the CEO, the Board and senior management team on matters relating to compliance.
    • The Director of Compliance is authorized to implement all necessary actions to ensure achievement of the objectives of an effective compliance program once approved and/or reviewed by the CEO.

    Responsibilities

    Responsibilities

    • Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct. Manages day-to-day operation of the Compliance Program.
    • Develops and periodically reviews and updates Standards of Conduct to support efforts in continuing currency and relevance in providing guidance to management and employees.
    • Annually assesses the effectiveness of the Compliance Program and revises the Program to reflect the organizations highest risks that will be monitored by the compliance function as determined by conducting risk assessments.
    • Maintains current knowledge of laws and regulations, keeping abreast of recent and/or pending changes.
    • Reports on a Quarterly basis to the Board of Directors on Compliance monitoring, findings, investigations, and corrective actions.
    • Facilitates review of payor audits.
    • Collaborates with all departments to direct compliance issues to appropriate existing channels for investigation and resolution.
    • Consults with the Corporate attorney as needed to resolve difficult legal compliance issues.
    • Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures.
    • Develops and oversees a system for uniform handling of such violations.
    • Acts as an independent review and evaluation body to ensure that compliance Issues/concerns within the organization are being appropriately evaluated, investigated and resolved.
    • Establishes an annual internal monitoring program to assess at least three high risk areas to monitors the performance and related activities on a continuing basis, taking appropriate steps to improve its effectiveness.
    • Coordinates internal compliance reviews and monitoring activities
    • Facilitates coordination with outside entities for subject matter expertise conducting identified reviews.
    • Independently investigates and acts on matters related to compliance, including the flexibility to design and coordinate internal investigations (i.e.: responding to reports of problems, ‘hot-line’ calls, or suspected violations) and any resulting corrective actions with all health system departments, providers and sub-providers, agents, and if appropriate, independent contractors.
    • Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
    • Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future.
    • Provides reports on a regular basis, and as directed or requested, to keep the Corporate Compliance Committee of the Board and senior management informed of the operation and progress of compliance efforts.
    • Makes certain proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
    • Establishes and provides direction and management of the compliance Hotline.
    • Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline; (b) heightened awareness of Standards of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.
    • Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.
    • Develops, coordinates, and participates in a multifaceted educational and training program that focuses on the elements of the Compliance Program, and seeks to make certain that all appropriate employees and management are knowledgeable of, and comply with, pertinent federal and state standards.
    • Develops materials at an organization-wide level for distribution to all employees to enhance awareness of compliance activities, including posters.

    Qualifications

    Required Education and Experience

     

    Education:

    Bachelors’ degree in related field required with at least five (5) years’ experience directly related to the duties and responsibilities specified.

     

    Experience:

     A minimum of five (5) years’ experience in a healthcare organization, to include demonstrated leadership.  Familiar with operational, financial, quality improvement, and human resources procedures and regulations required. 

     

    Previous experience in a Compliance role is required, preferably at a manager position or above.

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