PATTON - FULLER COMMUNITY HOSPITAL

EXECUTIVE OFFICERS
JOB DESCRIPTION

POSITION:

Chief Compliance Officer

DESCRIPTION:

Oversees the Compliance Program, functioning as an independent and objective body that reviews Hospital policies and evaluates compliance issues/concerns within the organization. The position ensures that the Board of Directors, management and employees are in compliance with the rules and regulations of federal and state regulatory agencies, that company policies and procedures are being followed, and that behavior in the organization meets the company�s Standards of Conduct. Responsible for developing, implementing, and maintaining a system-wide Corporate Compliance program. Oversees the Security Officer, the Director of Medical Records and the Director of Q.A. / Risk Management.

The position requires leadership skills to assist the organization to continually focus on compliance. The leadership skills include the ability to articulate a vision for the organizations compliance program and motivate the organization to achieve excellence in these areas. The position requires outstanding communication skills in order to effectively interface with all levels of management and staff. Position also requires the analytical ability and information systems experience required to design data collection systems, data analysis, and reporting mechanisms to measure and continually monitor compliance.

JOB DUTIES:   Job duties listed are the essential functions of this job title

1. Develops, initiates and revises policies and procedures for the general operation of the Compliance Program.
2. Manages day-to-day operation of the Compliance Program to prevent illegal, unethical or improper conduct.
3. Develops and periodically reviews and updates Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees.
4. Collaborates with other departments (e.g., Chief Medical Officer, Chief Financial Officer, Chief Operations Officer, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution.
5. Consults with the Hospital�s attorneys as needed to resolve difficult legal compliance issues.
6. Provides education and direction to maintain effective policies and procedures with all Hospital departments and staff. Provide compliance education at management orientation and new nursing venues.
7. Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures. Develops and oversees a system for uniform handling of such violations.
8. Acts as an independent review and evaluation body to ensure that compliance issues/concerns within the organization are being appropriately evaluated, investigated and resolved.
9. Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
10. Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
11. Provides reports on a regular basis, and as directed or requested, to keep the Corporate Compliance Committee of the Board and senior management informed of the operation and progress of compliance efforts.
12. Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
13. Establishes and provides direction and management of the Compliance Hotline.
14. Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline; (b) heightened awareness of Standards of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.
15. Institutes and maintains a system to collect, organize and archive patient medical records.
16. Research, review and assimilate regulatory law, rules, transmittals and policies that affect acute care coding and billing in the hospital setting. Direct clinical departments when responding to regulatory requirements for coding/billing to all third party payers including Medicare and Medicare Advantage beneficiaries.
17. Establishes a security force and institutes and maintains policies and procedures to ensure the physical safety of the hospital, its employees and patients.

EDUCATION AND EXPERIENCE:

1. A Master�s Degree OR a Bachelor�s degree with 8 years related experience. Master�s degree is preferred.
2. A minimum of 5 years experience in a healthcare organization with 3 years of experience in a supervisory or project leader role.
3. Certified coder with acute care ICD-9-CM and CPT-4 coding experience. Certified Healthcare Compliance Professions (CHC).
4. The preferred candidate will have seven years of experience in healthcare as a manager, project director or consultant who has knowledge of privacy laws, information systems,clinical applications or health information management. Will have knowledge of Medicare DRG and APC systems and local coverage determinations. Experience working in a regulatory agency may be helpful.
5. The preferred candidate would possess an advanced degree (i.e., J.D., Ph.D.) or certification(s) (i.e., CPA; certification as an RHIA or RHIT; a Certified Healthcare Executive (CHE); a certified education or instructor; Project Management Institute (PMI) certification or a related certification).