Deputy Chief Ethics & Compliance Officer

EDUCATION: Equivalent experience will be accepted in lieu of the required degree or diploma

Master's: Business Administration (MBA), Healthcare Administration (MHA), Public Health (MPH) or related field

CERTIFICATION & LICENSURE:

CHC-Certified in Healthcare Compliance

TYPICAL EXPERIENCE:

12 Years of recent relevant experience.

SKILLS AND KNOWLEDGE:

Comprehensive expertise in managing an effective ethics and compliance program, including: infrastructure development; policy management; training; monitoring/auditing; conducting and documenting investigations; addressing and resolving violations, errors, and deficiencies; tracking corrective actions, performing risk assessments, and designing strategies to prevent future compliance problems.

Expert level knowledge of healthcare compliance standards, compliance program development and assessment, relevant healthcare operational issues, business ethics and compliance risks and the knowledge to effectively manage those risks in a dynamic healthcare environment.

Expert level of knowledge regarding healthcare operations, revenue cycle, billing, coding and federal and state reimbursement program requirements (e.g., Medicare and Medi-Cal).

Well versed in current regulations that govern healthcare operations, including the California Knox-Keene Act, California Insurance Code, Office of Inspector General (OIG) Work Plan, Affordable Care Act and Health Insurance Portability and Accountability Act (HIPAA) regulations, in addition to federal and state reimbursement program requirements (e.g., Medicare and Medi-Cal), Internal Revenue Code, Employee Retirement Insurance Security Act (ERISA), Americans with Disabilities Act, privacy and consent laws, and licensure requirements, and quality standards.

Expert level knowledge of 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.

Expertise in current and emerging business ethics and compliance topics, project management methodologies and tools, resource management and change management techniques.

Detailed knowledge of other disciplines outside own area of expertise, including strategy, clinical disciplines, human resources, finance, clinical and financial auditing, and information technology.

Superior business acumen and exceptional leadership skills to provide innovative solutions to complex problems and leveraging appropriate internal/external resources to meet corporate objectives.

Exceptional managerial and organization skills required to create plans and strategies with the proven ability to articulate the value of these plans/strategies, assemble consensus across all levels of the organization, and lead others through change.

Advanced management skills, including the ability to facilitate and manage multiple complex projects simultaneously while efficiently and effectively achieving objectives.

Expertise with attention to detail, superior analytical and strategic planning skills with the ability to identify potential issues/risks/trend, analyze data, provide insights to staff and affiliates, and recommend actions to resolve or minimize the impact.

Excellent written/verbal interpersonal communication skills with the ability to articulate a vision, translate complex business ideas into lay terms, and to engage with diverse audiences, including peers, senior leadership, internal/external legal parties, insurance brokers, and government agencies.

Proficient computer and related software application, including Microsoft Office suite (Word, Excel, PowerPoint), including a working knowledge of data management to interpret information and track results, and internet-based legal and regulatory research.

Ability to

• translate vision into a tangible plan and develop clear ethics and compliance goals/objectives that support the strategic plan.
• influence others outside of direct reporting relationships or lines of authority, from senior management and the Board to those providing direct patient care and services.
• analyze problems and issues from a variety of perspectives to understand the legal, clinical, and human resource impact of decisions.
• develop cross-functional teams, foster consensus, resolve conflicts, and manage risk, in addition to being an effective decision maker and expert delegator.
• foster an environment of collaboration at all levels of the organization, including engaging influencing individuals or groups, building consensus, and then enlisting cooperation without direct control/ authority.
• establish, build, and maintain working relationships with staff, peers, senior leadership, physicians, existing and potential vendors, governmental agencies, and industry organizations.

Job Shift:

Days