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Organization TypePublic Interest
Years of Experience
Date Last Verified
Compliance Officer Duties: Administers the Ethics and Compliance Program at Medical Foundation by implementing systems and processes designed to ensure compliance with applicable laws, regulations and standards (e.g., Department of Health and Human Services Departments, including the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG)). Assists senior management and governance boards in carrying out their respective roles and responsibilities by providing compliance monitoring, reporting, training and advice.
Qualification and Experience
Qualifications: A Bachelorâ€™s degree or clinical degree in health care related field with substantial experience in healthcare compliance will be considered. Masterâ€™s degree preferred. (e.g., MPH, MBA, MHA, JD Degree, MD, etc.). Certification in Healthcare Compliance required. A law degree, admission to the State Bar of California, and substantial experience in health care and compliance law may be considered as substitution for Certification. Must have demonstrated significant business and/or healthcare compliance experience, including working with senior leaders. Experience working with a governing Board is strongly desired. This level of experience is typically obtained in 7 years of increasingly responsible experience in a health system or healthcare law or healthcare consulting environment. Must have a working knowledge of management of an effective ethics and compliance program, including training, monitoring, conducting and documenting investigations, addressing violations and monitoring corrective actions. Knowledge of healthcare compliance requirements strongly desired. Knowledge of other disciplines outside of own area of expertise, including business planning, clinical disciplines, human resources, finance, clinical and financial auditing, and information technology is desired. Must have demonstrated current knowledge of business ethics and legal and compliance risks and the knowledge to manage those risks in a dynamic health care environment. Should have working knowledge of federal and state reimbursement program requirements (e.g., Medicare and Medi-Cal), federal and state anti-kickback and physician self-referral laws (e.g., Stark and PORA), and provider and practitioner licensure and scope of practice requirements, privacy and consent laws. Must have a reputation for integrity and willingness to challenge higher levels of management on issues arising through the Ethics and Compliance Program. Must have the ability to translate/ provide cogent advice to senior management regarding the impact of emerging industry trends in compliance enforcement, legislation and regulations on affiliate business strategies and its not-for-profit mission. Must understand and lead by communicating vision, exhibiting decisiveness, sponsoring change and supporting the larger organization success. Must have the ability to translate vision into a tangible plan and develop clear ethics and compliance goals and objectives, supportive of the affiliate and Sutter Health strategic plan. Must be able to effectively influence others outside of direct reporting relationships or lines of authority â€“ from senior management and the Board to those providing direct patient care and services. Requires excellent verbal, written and presentation skills, including the ability to translate complex legal and regulatory requirements/ issues into terms readily understood by management, line and clinical personnel. Use of PC and common software including word-processing, email, and internet-based legal and regulatory research is required. Must exhibit a credible leadership presence, with the ability to respond to questions with logic, clarity, calmness and authority, leading to desired support of/ actions by others. Requires well-developed skills in problem identification/ analysis/ resolution, organization/ prioritization, timeliness and attention to detail. Must be adept at complex project planning/ management, with the ability to effectively delegate. Requires effective consulting skills. Must also be skilled in adult education.
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