Director of Compliance & Privacy

Position Responsibilities may include, but not limited to

• Develop, initiate, maintain, and revise policies and procedures for the general oversight of the compliance program and its related activities to prevent illegal, unethical, or improper conduct and ensure an effective compliance program with an emphasis on federal fraud and abuse laws and HIPAA 
• Responsible for oversight and management of Compliance staff for all compliance activities and serves as a resource on compliance issues 
• Provide leadership and expertise to help facilitate compliance with applicable statutes and policies 
• Provide leadership to the field on education of compliance and privacy requirements to include conducting training when necessary 
• Direct, design and execute a Compliance Risk Assessment and corresponding Work Plan 
• Design and conduct Compliance audits  
• Assess methods and procedures used to store and transmit PHI; identifies security or other compliance risks and researches and recommends improvements 
• Partner with senior leaders to align compliance strategies with business objectives 
• Serve as the point of contact for regulatory authorities and external compliance auditors 
• Investigate reports of compliance violations, and collaborate with internal and external counsel as appropriate to develop recommendations for corrective action and resolution 
• Oversee compliance hotline infrastructure and investigation 
• Monitor training programs for effectiveness and modify training schedule, methods and materials as appropriate to foster clear understanding of compliance responsibilities and ethical expectations across the organization 
• Serves as the internal subject matter expert on Privacy laws, including HIPAA, maintaining current knowledge of HIPAA laws and regulations, and any other applicable federal and state privacy laws or regulations 
• Report on changes in applicable laws and regulations and provides training as needed 
• Prepare dashboard, reports and other summaries of compliance program activities 

Required Skills and Experience

• Bachelor’s degree in Business, Law, Healthcare Administration, area of clinical expertise, or other related field
• 5-7 years’ experience in healthcare compliance, privacy, regulatory affairs or program management 
• Knowledge of federal and state healthcare regulations, including HIPAA, HITECH, the False Claims Act, the Anti-Kickback Statute, and CMS regulations
• Demonstrated experience advising executive leadership on compliance-related matters 
• Minimum of 3 years of experience managing a team, including hiring, coaching, performance management, and professional development 
• Strong facilitation, collaboration, and teamwork skills with the ability to build cross-functional partnerships to drive results 
• Ability to maintain confidentiality and navigate sensitive matters related to organization, employee and senior leadership situations 
• Ability to work autonomously with limited direction 

Preferred Skills and Experience

• Master’s degree in Business, Law, Healthcare Administration, area of clinical expertise, or other related field 
• Professional certification in Healthcare Compliance and/or Privacy (CHC, CPC, or similar designation) 
• 10 years’ experience in healthcare plan compliance, privacy, program management 
• Experience using compliance hotline vendor software, Governance, Risk, and Compliance (GRC) software, or compliance audit software to track, manage, and report on compliance activities

• Repetitive motions that include the wrists, hands and/or fingers
• Sedentary work that primarily involves sitting, remaining in a stationary position for prolonged periods
• Visual perception to perform job including peripheral vision, depth perception, and the ability to adjust focus