Job DescriptionSCOPE OF POSITION
Within Ballad Health Medical Associates (BHMA), the Director Risk Compliance will ensure alignment with Ballad Health’s mission and vision while responding to potential risk and regulatory concerns in an appropriate manner. This individual will collaborate with Sr. Leadership, Corporate Risk and legal to develop and implement policies needed to mitigate risk, ensure compliance with industry standards and regulations.
- Manage the external regulatory inquiries and responses, including working with outside counsel
- Develop, implement and maintain ongoing monitoring of compliance/risk throughout Ballad Health Medical Associates
- Develop policies for quality and patient safety, ensure all policies/procedures are in communicated and BHMA is in compliance
- Act as an expert resource for all BHMA quality and patient safety policies/procedures
- Responsible for organizational improvements and quality measures for all BHMA
- Develop and measure various clinical quality metrics, and quality improvement initiatives
- Develop the infrastructure to identify, manage and mitigate risk, to include filling gaps between the facility compliance plan and needs for BHMA
- Work collaboratively with leadership and clinicians to ensure compliance with health, safety, privacy, and professional regulations and standards to include education and promoting awareness of regulatory and other applicable standards
- Develop fraud, waste and abuse prevention protocols, including conflict of interest
- Review and assist with contracting and acting as a key negotiator when contract disputes arise
- Function as key company representative/liaison in meetings with federal/state agencies, and industry organizations regarding regulatory policy
- Provide education and training about actual, proposed, or pending legislation and regulations that affect operations and identify operational obstacles to compliance, and work with other team members to identify and implement solutions
- Report to Sr. Leadership or the Board on compliance-related matters as needed
- Perform other duties as assigned.
See Table of Organization.
EDUCATION AND EXPERIENCE
Required – Bachelor’s degree in nursing plus 10 years’ of combined Healthcare leadership, compliance and risk management.
Self-motivated, strong communication skills, ability to communicate with all levels, excellent organizational skills and manage multiple priorities.
Master’s Degree or Jurisprudence
Experience representing and advising healthcare entities on a variety of healthcare and privacy laws
Demonstrated knowledge of federal and state healthcare regulatory laws, including FDA regulation, laboratory compliance, fraud and abuse statutes, healthcare provider contracting, reimbursement and consumer protection