Assistant Director, Corporate Compliance - Signature Healthcare

Signature Healthcare is Southeastern Massachusetts’ premier local provider of quality, personalized medical services. We are comprised of the award-winning not-for-profit Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory locations. We believe our distinctive Signature Healthcare team approach is the way healthcare should be: medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference in the lives and health of our patients.

The Assistant Director, Corporate Compliance (Assistant Director) is a member of the Compliance Department and reports to the Chief Compliance Officer. This position is responsible for assisting the Chief Compliance Officer (CCO) with the institutional compliance program planning and execution. The Assistant Director will utilize prior hospital operations experience in support of the compliance program, perform or support compliance audits/investigations and risk assessments and serve as a resource to Signature Healthcare (SHC) on issues related to corporate compliance and ethical business practices.

Key Responsibilities:

• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.

• Commits to recognize and respect cultural diversity for all customers (internal and external).
• Communicates effectively with internal and external customers with respect for differences in cultures, values, beliefs and ages, utilizing interpreters when needed.

• Utilize strong background in hospital/health systems operations to contribute to an effective compliance program.
• Demonstrates initiative and strong organizational skills. Proactively identifies problems or concerns and takes the lead to reach resolution. Works collaboratively with SHC clinicians, management and staff to meet regulatory or government program requirements, and to identify and address compliance concerns.
• Strong research and analytical skills and understanding of applicable regulatory or government program requirements. Clearly communicate such requirements to management, clinical and operations staff.

Conducts and coordinates compliance investigations and audits including, but not limited to matters related to Anti-Kickback Statute, Stark Law, Exclusion statute, EMTALA, Beneficiary Inducement, and other State and Federal non-privacy healthcare laws and regulations. Collaborates with members of the Legal Staff to address legal requirements and identified issues.

• Supports internal and external audits of HCPCS, CPT coding, DRG coding, and medical record reviews, using proven healthcare audit methodology, with a focus on government payers, including Medicare and Medicaid. Collaborate with SHC’s Healthcare’s Compliance Auditor to meet audit plan objectives.
• Works with SHC management to ensure that all staff, including clinicians, are aware of the compliance hotline and that SHC managers have a process for receiving, documenting, tracking, investigating and taking action on compliance incidents and complaints.
• Applies knowledge of Medicare and Medicaid programs, state insurance and health care laws, HITECH, HIPAA and general Corporate Compliance principles. Maintains up-to-date knowledge of health care legal requirements, and determines if policy revisions or operational changes are required to demonstrate compliance.
• Develops and facilitates individual, small group and large audience education programs, addressing compliance issues or new regulatory requirements. This includes provider and coding education, in collaboration with Health Information Management staff.
• Work with CCO, clinicians and management to identify areas of noncompliance, risk areas, requiring corrective actions. Monitor successful implementation and sustainability of corrective actions. With CCO, recommend specific sanctions and appropriate disciplinary measures.
• Initiates and tracks project timelines for assigned areas to meet deadlines of SHC initiatives and programs and to ensure timely implementation of regulatory requirements.
• Under direction of the CCO, support risk assessment activities and analyze data related to key risk areas to identify gaps in processes and existing practices that should be deployed throughout the organization. Also, analyze risk assessment data for errors and investigate variances.
• Collaborate with SHC’s Privacy Officer to ensure that SHC’s Privacy program meets all applicable requirements.
• Collaborate with clinical and administrative staff to support projects and new initiatives, provide compliance guidance to accomplish management objectives. Cover for CCO, if CCO is not available.
• Perform other duties as assigned.

Responsbilitilites

• Working knowledge of MS Office (i.e. Excel, Word and PowerPoint). Ability to present a variety of information to a diverse audience.
• Ability to solve practical problems and the flexibility to deal with situations, where only limited standardization may exist.
• Maintain appropriate degree of confidentiality.
• Use appropriate judgment in communications and actions with patients, physicians, other associates, outside agencies, and vendors.
• Ability to effectively communicate with all staff levels, members of management, physicians, and midlevel providers. Effectively communicates in the English language, both verbally and in writing.
• Exhibits clear, concise writing and presentation skills. Detail oriented with strong organizational skills.

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