Essential Roles and Responsibilities
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
- Lead the organization's regulatory affairs program for HME/DMEPOS operations across all markets
- Monitor, interpret and implement changes to Licensure as it relates to Medicare and other state regulatory requirements
- Oversee PECOS enrollment, NPI Registry, organization licensure and regulatory research to ensure uninterrupted billing privileges
- Ensure compliance with DMEPOS Supplier Standards, Medicare regulations and accreditation requirements
- Collaborate with Legal, Compliance, Revenue Cycle, Credentialing, Clinical Operations and Executive Leadership to identify regulatory risks and implement corrective actions
- Provide regulatory guidance for licensure as it relates to the shipment of products to organization locations
- Support mergers, acquisitions and new market expansion by managing regulatory due diligence, licensure and enrollment activities
- Develop and maintain regulatory policies, procedures and internal controls while educating leaders on regulatory changes and compliance expectations
Qualifications
- Associate degree in Healthcare Administration, Business, Nursing, Respiratory Therapy, Legal Studies or a related field preferred
- Minimum of eight (8) years of progressive experience in healthcare regulatory affairs, compliance, provider enrollment, reimbursement or healthcare legal operations
- Minimum of five (5) years of experience within the HME, DMEPOS, home respiratory, home health or post-acute healthcare industry
- Experience managing Medicare supplier enrollment, state licensure, accreditation and multi-state regulatory compliance
Preferred Knowledge, Skills and Abilities
- Extensive knowledge of PECOS, NPPES/NPI Registry
- Working knowledge of LCDs, NCDs, HIPAA, OIG Compliance
- Experience with accreditation organizations, including HQAA, ACHC and Joint Commission
- Strong analytical, organizational and project management skills with the ability to interpret complex regulations and implement operational solutions
- Excellent communication and relationship-building skills with experience collaborating across legal, compliance, operations, revenue cycle and executive leadership
You will be expected to work during normal business hours, which are Monday through Friday, 8:00 a.m. to 5:00 p.m. Please note this job description is not designed to cover and/or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Essential duties and responsibilities may change at any time, with or without notice.
