Job Title: VP & Compliance Officer
Position OverviewThe VP & Compliance Officer is a key member of West Cancer Center's leadership team and provides independent and objective leadership of the organization's healthcare compliance program. This position is primarily responsible for the establishment, implementation, operation, and continuous improvement of the compliance program and is accountable for its effectiveness.
The VP & Compliance Officer oversees the identification, assessment, monitoring, investigation, and remediation of compliance risks and serves as a resource and advisor to the Chief Executive Officer, senior leadership, providers, employees, and other stakeholders regarding compliance matters. This position also serves as West Cancer Center's primary HIPAA Privacy Officer and oversees the privacy compliance program.
Key ResponsibilitiesCompliance Program- Serve as the primary leader and accountable owner of West Cancer Center's healthcare compliance program
- Establish, maintain, and continuously improve an effective compliance program consistent with applicable laws, regulations, regulatory guidance, and recognized compliance practices
- Conduct or oversee annual compliance risk assessments and develop risk-based compliance work plans
- Identify compliance risks and recommend appropriate controls, education, monitoring, and risk mitigation strategies
- Establish compliance metrics and reporting processes to evaluate program effectiveness
Policies, Education, Auditing & Monitoring- Develop, review, implement, and maintain compliance policies and procedures in collaboration with appropriate leaders and subject matter experts
- Oversee compliance education and training and promote ethical conduct, regulatory awareness, and non-retaliation
- Develop and oversee risk-based compliance auditing and monitoring, including billing, coding, documentation, reimbursement, medical necessity, provider arrangements, privacy, and other identified risk areas
- Coordinate responses to governmental, regulatory, accreditation, payer, and other external audits or inquiries
- Evaluate audit and monitoring results and oversee appropriate compliance remediation
Investigations & Remediation- Receive and evaluate reports indicating potential violations of healthcare laws, regulations, regulatory requirements, or conduct that may create significant compliance risk
- Conduct or oversee compliance investigations and coordinate with Human Resources, operational leadership, or other appropriate parties as needed
- Evaluate the scope, root cause, and potential impact of substantiated compliance concerns
- Develop and monitor compliance remediation plans addressing regulatory violations, process deficiencies, control weaknesses, and systemic risks
- Recommend improvements to policies, procedures, controls, workflows, education, and monitoring to mitigate risk and prevent recurrence
- Escalate significant or unresolved compliance concerns to the Chief Executive Officer
- Coordinate with Human Resources when a compliance investigation identifies employee misconduct directly related to the compliance concern; Human Resources retains responsibility for determining and administering disciplinary or other employment action
Regulatory Compliance, Fraud, Waste & Abuse- Monitor and communicate changes in applicable healthcare laws, regulations, regulatory guidance, and enforcement priorities
- Provide compliance guidance to leadership, providers, and departments regarding regulatory requirements and identified risks
- Oversee compliance activities related to fraud, waste, and abuse, including applicable requirements under the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, and Medicare and Medicaid programs
- Coordinate appropriate investigation, remediation, reporting, disclosure, and repayment activities when potential fraud, waste, or abuse is identified
HIPAA Privacy- Serve as West Cancer Center's primary HIPAA Privacy Officer and oversee the privacy compliance program
- Monitor compliance with HIPAA Privacy, Security, and Breach Notification requirements
- Oversee privacy complaints, suspected unauthorized access, use or disclosure of protected health information, and potential breaches
- Provide guidance regarding the appropriate use and disclosure of protected health information and coordinate investigation, mitigation, documentation, and required reporting of privacy incidents
Leadership & Governance- Provide regular reports to the Chief Executive Officer, senior leadership, and/or applicable Board committee regarding significant compliance risks, investigations, audit findings, remediation, and program effectiveness
- Provide independent and objective advice regarding significant compliance risks and emerging regulatory issues
- Participate in appropriate leadership, governance, risk, privacy, quality, and other committees
- Maintain appropriate independence and access to records, systems, personnel, and information necessary to fulfill compliance responsibilities
- Foster a culture in which compliance concerns are identified, reported, investigated, and appropriately addressed
QualificationsEducation & ExperienceRequired:- Bachelor's degree in Business, Healthcare Administration, Compliance, or a similar field
- Minimum of five (5) years of progressive healthcare compliance or related experience
- Experience administering a healthcare compliance program, including risk assessment, auditing, monitoring, investigations, and remediation
- Experience working with physicians, executive leadership, employees, and governing bodies
Preferred:Master's degree, JD, or other relevant master's degree
Credential/LicensurePreferred:- Certified in Healthcare Compliance (CHC), CHPC, CHRC, CCEP, CIA, CPC, or other compliance, auditing, or privacy credential
Knowledge, Skills & Abilities- Strong knowledge of healthcare laws, regulations, regulatory requirements, compliance principles, HIPAA, and fraud, waste, and abuse requirements
- Knowledge of healthcare billing, coding, documentation, reimbursement, medical necessity, and related regulatory risks
- Strong analytical, investigative, critical-thinking, and problem-solving skills
- Excellent written and verbal communication skills, with the ability to explain complex regulatory requirements to diverse audiences
- Demonstrated integrity, sound judgment, discretion, independence, and objectivity
- Ability to identify and appropriately address compliance risks and challenge practices when warranted
- Ability to manage confidential and sensitive information
- Ability to work effectively with physicians, providers, executives, managers, employees, and external regulatory and oversight entities
Work Environment & Physical Demands- Physical activities may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion
- Must have good balance and coordination
- Light work requiring exertion of up to 25 pounds of force occasionally and/or up to 10 pounds of force frequently
- Close visual acuity is required for activities such as preparing and analyzing data and figures, transcribing, viewing a computer terminal, and extensive reading
- The position is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work
No nights, weekends, or holidays. Comprehensive benefits package.Join UsIf you are an experienced healthcare compliance professional with a strong background in compliance program leadership, regulatory oversight, auditing, investigations, risk assessment, and privacy compliance, we encourage you to apply for the VP & Compliance Officer position at West Cancer Center.
