- Provide leadership for the corporate ethics and compliance program
- Update and maintain compliance policies and procedures in accordance with federal/state regulatory requirements to prevent, detect and correct non-compliance with applicable law, including identifying potential fraud, waste and abuse and non-compliance with HIPAA and related privacy and security regulations.
- Implement audit initiatives, conduct Privacy Impact Assessments (PIA), oversee internal audit operations, and provide leadership and direction in communicating and monitoring audit policies, procedures, practices, programs and processes
- Serve as the primary contact for the Centers for Medicare & Medicaid Services (CMS) and other regulatory agencies, responsible for official responses regarding issues, complaints and enforcement actions.
- Identify risk proactively, and corrective actions, investigate reported non-compliance and Code of Conduct violations, and ensure non-compliance issues are promptly investigated and resolved
- Provide education and training on the Code of Conduct, compliance, guidance, laws and regulations
- Oversee vendor risk assessments
- Work diligently to foster a culture and climate of sensitivity to ethical and compliant behavior within the organization
- Identify the appropriate resources necessary to manage the ethics and compliance program and establish a budget to support such resources
- Effectively communicate ethics and compliance standards to the organization's employees and contractors and vendors, as appropriate
- Coordinate and monitor team member and board training regarding compliance with laws, regulations, and corporate policies
- Support corporate monitoring and auditing procedures of business conduct practices (corporate team and, as appropriate, management company personnel will be involved in this process)
- Support, with senior leadership, corporate monitoring and auditing procedures of clinical practices
- Advise the board of directors, senior leadership, team members, and affiliates on ethics and business conduct issues as necessary and appropriate
- Coordinate internal investigations of alleged violations of ethics and compliance standards
- Review all internal compliance, audit reports, and investigation reports pertaining to the organization
- Work with outside consultants and counsel about ethics and business conduct issues with the ethics and compliance committee
- Take prompt corrective actions in response to identified concerns or problems, as well as preventive actions where potentials for concern are identified
- With the ethics and compliance committee, initiate immediate remedial actions as warranted by extreme circumstances or recommend remedial actions to the board of directors and senior leadership to correct unethical or noncompliant clinical or business conduct activities
- Serve as a liaison to the organization's board of directors and senior management on ethics and compliance standards and business conduct issues
- Make periodic reports, as designated in the compliance policies and procedures, or as necessary, to the board of directors and leadership regarding ethics and compliance program activities.
- Bachelor's degree in Business Administration or other related degree preferred 10+ years' experience in a healthcare compliance role handling HIPAA and Privacy/Security, healthcare plans, or a related field in the healthcare industry
- CHC or CHCP certification, preferred
- Exemplifies knowledge of healthcare compliance, contract law, accounting principles and finance
- Proficient in MS Office applications and ability to learn department and job-specific software systems
- Demonstrate organizational skills
- Demonstrate effective verbal and written communication skills
- Demonstrate analytical skills when problem-solving
- Demonstrate high attention to detail and a high degree of accuracy
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VP, Compliance - Nashville, United States - Wellvana
Description
ApplyDescription
Who we are:
The healthcare system isn't designed for health. We're designed to change that. We're Wellvana, and we help doctors deliver life-changing healthcare.
Through our elevated value-based care programs, we're revitalizing an antiquated system that's far too long relied on misaligned incentives that reward quantity of care not the quality of it.
Our enlightened approach-covering everything from care coordination to coding to marketing- ties the healthy outcomes of patients directly to healthier earnings for primary care providers.
Recently named by Insider as one of 33 startups "investors expect to take off in 2023," we're one of the fastest-growing healthcare companies in America because what we do works.
The Role:
We're looking for a VP, Compliance to provide centralized oversight of the organizations compliance efforts, including the administration, investigation, and enforcement of Wellvana's compliance and ethics plans and policies.
The VP, Compliance will serve as the point person for all compliance programs and activities, and will play a crucial role in developing, implementing, and maintaining an effective compliance program.
This role will report to our Chief Executive Officer.What you'll do:
Who you are:
