Career Center

Medical Center Compliance Officer

JOB SUMMARY

Under the general direction and supervision of the Vanderbilt University Medical Center Chief Compliance Officer, the Affiliates Compliance Officer works directly with the Vanderbilt University Medical Center Office of Compliance and Corporate Integrity (OCCI) and with the entity leadership teams of Vanderbilt Health System (VHS) and the VHS Affiliates to maintain and continuously improve effective compliance programs to prevent and detect potential regulatory compliance problems while partnering with leadership to increase overall efficiency and effectiveness of clinical, financial and administrative operations. The Affiliates Compliance Officer will be responsible for the oversight of and guidance related to federal and state regulatory and payment requirements and private contracting issues relevant to the prevention and/or detection of fraud, waste and abuse by the assigned entities and their employees and agents.

KEY RESPONSIBILITIES

• • Consultation. Represent the compliance function in advice to VHS and VHS Affiliates leadership and process improvement analysis
  • Knowledge. Maintain extensive and current knowledge of health care compliance in the areas of health care laws, regulations, manual instructions, documentation and billing, including requirements that pertain to the Medicare and Medicaid programs, the Physician Sell-Referral (Stark) law, the federal Antikickback statute, the federal Civil False Claims Act and the Health Insurance Portability and Accountability Act (HIPAA) privacy rules.
  • Policy Development. Coordinate groups and functions to develop and maintain effective and clear policy and procedure applicable to VHS and VHS Affiliates
  • Internal Controls. Review and recommend controls and processes implemented by employees and systems to verify appropriate operations
  • Inquiries. Lead investigations into allegations of errors or process improprieties within the entity
  • Liaison. Direct and monitor the compliance efforts of VHS and VHS Affiliate-designated Compliance Officers. Serve as a liaison between external regulatory auditors and reviewers and the assigned entities
  • Collaboration. Facilitate communication among OCCI, VHS and the VHS Affiliates with respect to other compliance functions, such as education and auditing & monitoring, to minimize regulatory risk and maximize clinical, financial and administrative efficiency

BASIC QUALIFICATIONS

• • Bachelor's Degree (or equivalent experience) (Required)
  • 5 years experience (Required)

PREFERRED QUALIFICATIONS

• At least 10 years relevant experience as a Corporate Compliance or Ethics Officer, health care attorney or equivalent
• A CPA, Internal Audit Certification, Professional Coding Certification, Master's Degree or Juris Doctor.
• Certification in Healthcare Compliance (CHC)
• Knowledge of the Compliance risks associated with a broad array of health care entities including, but not limited to, Home Health Agencies, Physician Groups, Ambulatory Surgery Centers, Imaging Centers, Accountable Care Organizations, and Radiation Oncology Providers.
• Prior experience working with state and federal regulatory and law enforcement agencies to resolve compliance disputes successfully
• Prior experience with federal antitrust laws, regulations and principles
• Prior management supervisory experience
• Excellent organizational skills
• Demonstrated ability to plan, manage and work independently on large projects and initiatives