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Responsible for planning and directing the implementation of the WV University Health System (WUVHS) compliance strategy at designated facilities or a designated region. Responsible for oversight and management of a moderate sized hospital ‘system’ that includes greater than three legal entities. This oversight includes implementing the corporate code of conduct, corporate policies, corporate policies/procedures to prevent, detect, and correct violations of laws, rules, regulations, or contractual obligations, by employees, officers, or other agents of each department, within the organization. Ensures that the entities and the region under their specific oversight maintain ongoing compliance with federal and state government rules and regulations in addition to WVUHS policies and procedures. May manage central personnel for work plan completion at other sites at the request of the Chief Compliance Officer. May supervise an individual or small team. May be assigned to coordinate activities for and/or mentor one or more local compliance directors.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s degree in healthcare administration, business administration, or related field AND successful completion of CHC (Certified in Healthcare Compliance). 

OR

Associates Degree in healthcare administration, business administration, or related field; 4 years of compliance related experience AND successful completion of CHC (Certified in Healthcare Compliance) certification within one (1) year of hire date. 

EXPERIENCE:

1. Seven (7) years of experience in a healthcare organization including compliance, coding, and/or billing/revenue cycle knowledge.

2. Four (4) years of experience in health care management position.

 

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. CPC, COC certification through AAPC; RHIT or CCS-P certification through AHIMA.

2. CHC certification through Health Care Compliance Association.

EXPERIENCE:

1. Two (2) years supervisory experience

 

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

 

1. Responsible for oversight and management of individual facilities and/or a region as assigned to ensure overall compliance requirements and standards are upheld for his/her areas of assignment and under his/her compliance umbrella and for whom he/she has overall compliance responsibility.

2. At the request of the Chief Compliance Officer this individual may also manage central personnel or functions at other system sites in order to achieve enterprise-wide goals and initiatives.

3. Implements system level corporate code of conduct, policies, and procedures to prevent, detect, and correct violations of laws, rules, regulations, or contractual obligations, by employees, officers, and other agents within WVUHS.

4. Develops, maintains and supports the implementation of all ongoing efforts of the Compliance Program by serving on committees, promoting compliance awareness, and supporting the compliance hotline process.

5. Conducts an annual risk assessment and based on the results and risk factors, develops a local annual work plan and contributes to the development of the system level internal audit and compliance work plans.  Constantly evaluates work plans and makes revisions as needed as determined by the industry and/or internal needs.

6. Coordinates the process of auditing and monitoring associated with the compliance work plan.  Presents completed reports to the respective management team and monitors associated corrective action plans.

7. Coordinates initial and ongoing compliance training (code of conduct, fraud, waste and abuse, conflict of interest, etc.) and educational efforts on compliance for all levels of the organization, including the Board of Trustees, executives, managers, employees and professional staff.

8. Develops and maintains a routine reporting process to the Board of Directors, Compliance Committee, and senior leadership with timely and relevant information on the status of programs, internal audits, and periodic risk assessments on compliance issues.

9. Coordinates and provides assistance to the WVUHS Chief Compliance Officer in compliance matters. Upon request of WVUHS Chief Compliance Officer, shall do the following, act as coordinator with any outside counsel in regard to any compliance issues and review any contracts regarding compliance.

10. Pursues education and training opportunities to assure compliance with current laws, rules and regulations by participating in professional education activities, obtaining and maintaining relevant certifications, and networking with industry peers.

11. May coordinate activities with external auditors at the request of the CCO.

12. May be responsible for developing and maintaining budgetary activities for specific areas of oversight.

13. Responsible for completion of employee evaluations, development plans, maintenance of personnel files, etc.

 

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. Extended periods of sitting. 

2. Extended periods of computer and telephone usage. 

3. Must be able to move throughout the department work areas.

4. Must have clarity of speaking and hearing.

5. Must be able to identify deficiencies in the control environment based on evidential data and the ability to identify any deficiencies resulting in financial loss or regulatory noncompliance.

 

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. Standard office environment

 

SKILLS AND ABILITIES:

 

1. Excellent organizational and time management skills.

2. Outstanding verbal and written communication skills.

3. Excellent presentation skills preferred.

4. Ability to utilize electronic medical record and billing systems.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

508 SYSTEM Compliance

Address:

1025 Market Street

Wheeling

West Virginia

Equal Opportunity Employer

 

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.