The Office of Healthcare Compliance is seeking a Hospital Compliance Officer , experienced in the broad range of contracting, processes, systems, documentation and billing regulatory issues that may present to a (271) bed free-standing, specialty children's hospital within an academic medical, tertiary care and Level 1 trauma center (MCJCHV). In this pivotal role, you will report to the medical system compliance office, but will work directly with the hospital leadership teams to prevent and detect potential regulatory compliance problems while partnering with that leadership to increase overall efficiency and effectiveness of clinical, financial and administrative operations.
You will work with the Compliance Office to ensure that the Institution implements and maintains an effective compliance program that includes:
Written standards of conduct and policy
A dedicated Compliance Officer and oversight Committee
Regular training of employees
A process to receive complaints
Audits to monitor compliance
Investigate process for identified concerns
Enforcement of standards and remedy of validated allegations
You 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 MCJCHV and its employees and agents.
Key Responsibilities :
Consultation. Represent the compliance function in advice to hospital leadership and process improvement analysis
Knowledge. Maintain extensive and current knowledge of health care compliance in the areas of hospital contracting, processes, systems, documentation and billing
Policy Development. Coordinate groups and functions to develop and maintain effective and clear policy and procedure applicable throughout MCJCHV
Internal Controls. Review and recommend controls and processes implemented by personnel and systems to verify appropriate operations
Inquiries. Lead investigations into allegations of errors or process improprieties at MCJCHV
Liaison. Serve as a liaison between external regulatory auditors and reviewers and MCJCHV
Collaboration. Facilitate communication between MCJCHV personnel and other functions of the Compliance Office, such as education and auditing & monitoring, to minimize regulatory risk and maximize clinical, financial and administrative efficiency
A day in the life of this role may include :
Providing compliance advice and guidance to hospital leadership.
Supporting the development and implementation of processes to strengthen internal controls.
Collaborating with hospital departments to direct compliance initiatives and process improvement controls.
Monitoring and researching applicable state and federal regulations and defined compliance policies and procedures to ensure that operational activities meet federal and state requirements.
Overseeing and maintaining MCJCHV's compliance program to include annual compliance policy and procedure review.
Coordinating internal control and compliance reviews including risk assessments of compliance areas, assessing the adequacy of functional compliance policies and procedures, and reporting the results to MCJCHV leadership.
Responding to and investigating allegations of violations of the compliance program at MCJCHV.
Reporting to Chief Compliance Officer and participate in system wide compliance initiatives.
Advanced degree (MBA, MHA, JD, or related) is preferred. Certification in health care compliance is required.
5+ years of experience in health care compliance. Previous hospital experience highly desirable.
Experience with a non-profit academic medical center or other organization of similar complexity is preferred.
In-depth knowledge of the Federal and State laws and regulations governing health care.
Demonstrated experience in internal audit principles and practices. Knowledgeable of Medicare, Medicaid, and commercial payor enrollment and billing requirements.
Experience in analysis and in advising on regulatory requirements.
Experience as liaison and in coordinating activities between departments and functions and with various regulatory agencies.
Competency with Microsoft products (Project, Access, Visio, PowerPoint, Outlook, Excel, Word), web technologies and database tools, and willingness to learn new technologies when presented.
The Office of Healthcare Compliance manages VUMC's compliance program. Our office mission is to ensure and promote the highest standards of business ethics. VUMC is committed to complying with all federal and state laws, rules, and regulations. Specifically, our office is tasked with:
Preventing any accidental or intentional violations of law
Detecting violations if they occur
Immediately taking corrective measures if violations occur
Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity — of culture, thinking, learning and leading — is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.
VUMC Recent Accomplishments
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
· US News & World Report: #1 Hospital in Tennessee, #1 Health Care Provider in Nashville, #1 Audiology ( Bill Wilkerson Center ), 9 adult and 9 pediatric clinical specialties ranked among the nation's best, #15 Education and Training
· Truven Health Analytics: among the top 100 hospitals in the US
· Becker's Hospital Review: one of the "100 Greatest Hospitals in America"
· The Leapfrog Group: grade "A" in Hospital Safety Score
· National Institutes of Health: among the top 10 grant awardees for medical research in the US
· American Association for the Advancement of Science: 12 faculty members elected fellows in 2014
· Magnet Recognition Program: Vanderbilt nurses are the only group honored in Middle Tennessee
· Nashville Business Journal: Middle Tennessee's healthiest employer
· American Hospital Association: among the 100 "Most Wired" medical systems in the US
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As th...e largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.