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FTE
1
Scheduled Bi-Weekly Hours
80
Work Shift
Day: 8 hours
Job Description
Strategic Compliance Leadership
- Develop, own, and continuously evolve the strategic direction, policies, procedures, and annual work plan for El Camino Health's enterprise-wide compliance program, spanning the hospital setting, Medical Network, and all affiliated entities.
- Serve as a key advisor to leadership on compliance risk, regulatory change, and program effectiveness.
Compliance Program Management and Daily Operations
- Oversee day-to-day administration of the compliance program, including the compliance hotline and reporting channel, case intake, tracking, and issue resolution across the enterprise.
- Ensure alignment with applicable laws and regulations, including HIPAA, Stark Law, the Anti-Kickback Statute, the False Claims Act, CMS, accreditation standards, and commercial payer requirements, across all El Camino Health lines of business.
- Maintain and update the enterprise9s compliance policies, standards, and governance documents.
Monitoring, Auditing, and Investigations
- Lead and manage audits and ongoing monitoring activities related to billing, coding, documentation, referral patterns, and regulatory adherence across hospital, medical group, and ancillary operations.
- Conduct and document investigations of reported compliance concerns enterprise-wide and implement corrective action plans as needed.
- Oversee the organization's response to government audits, subpoenas, inquiries, and other compliance-related external reviews.
Education and Training
- Design, deliver, and continuously improve compliance education programs for physicians, employees, leaders, and contractors across all El Camino Health entities.
- Maintain ongoing, role-based training on the Code of Conduct, privacy and security, fraud and abuse prevention, and emerging regulatory topics.
Regulatory and Contractual Oversight
- Monitor federal and state regulatory developments and translate their implications into practical guidance for business and clinical operations.
- Review and support compliance provisions in contracts with payers, vendors, and business associates across the enterprise.
Reporting and Risk Management
- Prepare and, as needed, present compliance reports, dashboards, and risk assessments for leadership and the Board.
- Partner with support functions and clinical and operational leadership to identify, prioritize, and mitigate compliance risks across the enterprise.
- Integrate compliance risk data into El Camino Health's broader enterprise risk management program.
Qualifications
Minimum Requirements
Education: Bachelor's degree in Healthcare Administration, Law, Business, or a related field required; graduate degree or Juris Doctor (JD) preferred.
Experience: Minimum of 5 years of progressive healthcare compliance experience, with a preference for significant experience leading a compliance function across multiple entities or a complex, multi-site health system. Prior experience managing both the operational and strategic aspects of a compliance program is required.
Other: Certification in Healthcare Compliance (e.g., CHC, CHPC) or must be obtained in the first 24 months.
Knowledge, Skills, and Abilities
- Strategic, detail-oriented leader with deep knowledge of healthcare regulations and proven experience building and running compliance operations across a multi-entity health system.
- Deep knowledge of healthcare regulatory frameworks, compliance program elements, and enterprise risk management principles.
- Demonstrated ability to help lead an enterprise-wide compliance function spanning hospital, medical group, and ambulatory operations.
- Excellent communication, influencing, and relationship-building skills; ability to engage and educate physicians, executives, Board members, and staff at all levels.
- Proficiency in designing audit programs, corrective action plans, and regulatory filings.
- Ability to interpret complex, evolving regulations and translate them into practical operational guidance.
- High integrity, discretion, and sound judgment in handling sensitive and confidential matters.
- Strong project management skills, with the ability to balance daily operational demands with long-term strategic program development.
License/Certification/Registration RequirementsCertification in Healthcare Compliance, such as Certified in Healthcare Compliance (CHC) or Certified in Healthcare Privacy Compliance (CHPC) or must be obtained in the first 24 months.
Salary Range:
$94.12 - $141.18 USD Hour
The Physical Requirements and Working Conditions of this job are available. El Camino Health will provide reasonable accommodations to qualified individuals with a disability if that will allow them to perform the essential functions of a job unless doing so creates an undue hardship for the hospital, or causes a direct threat to these individuals or others in the workplace which cannot be eliminated by reasonable accommodation.
Sedentary Work - Duties performed mostly while sitting; walking and standing at times. Occasionally lift or carry up to 10 lbs. Uses hands and fingers. - (Physical Requirements-United States of America)
