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Date Last Verified
Years of Experience
ProfileDirector of Regional Compliance The candidate: Builds effective working relationships by collaborating with and influencing business leaders, diverse team members and clinicians, and business partners. Ensures that the Companyâ€™s operations are conducted in compliance with ethical business practices, applicable state and federal health care laws and regulations, organizational policies, and other laws and regulatory requirements. Assists in the implementation of the Code of Conduct and associated policies. Works in tandem with operations and clinical leadership, and attends regional and area leadership meetings and calls. Conducts, oversees, or assists with prompt investigation of allegations of non-compliance, collaborating with other departments and hospital partners as appropriate to minimize institutional risk. Identifies potential areas of compliance vulnerability and risk and ensures that corrective action plans are developed and implemented when compliance issues are revealed by investigations, audits, and other mechanisms. Develops and provides compliance-related education and guidance to clinicians and operators on topics such as the False Claims Act; the Anti-Kickback Statute; Stark Law; Medicare, Medicaid, TRICARE, and other applicable federal health care program requirements; the CIA; the Code of Conduct; and internal policies and procedures. Prepares and assists in drafting reports on compliance investigations and issues. Communicates with and updates senior leadership regularly and as appropriate. Provides assistance and guidance to other members of the Compliance Department. Performs other duties as required. Bachelorâ€™s Degree in Business Administration, Healthcare Administration, or related field is essential. J.D., MBA, or Masterâ€™s Degree in health care-related field preferred. Certified Professional Coder is a plus. Must have 7+ years of health care compliance-related experience, to include substantial experience conducting or overseeing health care investigations related to allegations of fraud, waste, and abuse or other compliance violations. Should have experience teaching or providing education to health care providers, investigators, or others. Familiarity with ICD-10, CPT, and HCPCS strongly preferred. Experience with or knowledge and understanding of billing, coding, and reimbursement regulations related to wound care or Hyperbaric Oxygen Therapy Treatment is preferred.
4500 Salisbury Road
Jacksonville, FL 32216