The Office of Healthcare Compliance is seekinga Hospital Compliance Officer, experienced in the broadrange of contracting, processes, systems, documentation and billing regulatoryissues that may present to a (271) bed free-standing, specialty childrenâshospital within an academic medical, tertiary care and Level 1 trauma center(MCJCHV). In this pivotal role, you will report to the medicalsystem compliance office, but will work directly with the hospital leadershipteams to prevent and detect potential regulatory compliance problems whilepartnering with that leadership to increase overall efficiency andeffectiveness of clinical, financial and administrative operations.
You will work with the Compliance Office toensure that the Institution implements and maintains an effective complianceprogram that includes:
Written standards of conduct and policy
A dedicated Compliance Officer and oversight Committee
Regular training of employees
A process to receive complaints
Audits to monitor compliance
Investigate process for identified concerns
Enforcement of standards and remedy of validated allegations
You will be responsible for the oversight of andguidance related to federal and state regulatory and payment requirements andprivate contracting issues relevant to the prevention and/or detection offraud, waste and abuse by MCJCHV and its employees and agents.
Consultation. Represent the compliance function in advice to hospital leadership and process improvement analysis
Knowledge. Maintain extensive and current knowledge of health care compliance in the areas of hospital contracting, processes, systems, documentation and billing
Policy Development. Coordinate groups and functions to develop and maintain effective and clear policy and procedure applicable throughout MCJCHV
Internal Controls. Review and recommend controls and processes implemented by personnel and systems to verify appropriate operations
Inquiries. Lead investigations into allegations of errors or process improprieties at MCJCHV
Liaison. Serve as a liaison between external regulatory auditors and reviewers and MCJCHV
Collaboration. Facilitate communication between MCJCHV personnel and other functions of the Compliance Office, such as education and auditing & monitoring, to minimize regulatory risk and maximize clinical, financial and administrative efficiency
A day in the life of this role mayinclude:
Providing compliance advice and guidance to hospital leadership.
Supporting the development and implementation of processes to strengthen internal controls.
Collaborating with hospital departments to direct compliance initiatives and process improvement controls.
Monitoring and researching applicable state and federal regulations and defined compliance policies and procedures to ensure that operational activities meet federal and state requirements.
Overseeing and maintaining MCJCHVâs compliance program to include annual compliance policy and procedure review.
Coordinating internal control and compliance reviews including risk assessments of compliance areas, assessing the adequacy of functional compliance policies and procedures, and reporting the results to MCJCHV leadership.
Responding to and investigating allegations of violations of the compliance program at MCJCHV.
Reporting to Chief Compliance Officer and participate in system wide compliance initiatives.
Advanced degree (MBA, MHA, JD, or related) is preferred. Certification in health care compliance is required.
5+ years of experience in health care compliance. Previous hospital experience highly desirable.
Experience with a non-profit academic medical center or other organization of similar complexity is preferred.
In-depth knowledge of the Federal and State laws and regulations governing health care.
Demonstrated experience in internal audit principles and practices. Knowledgeable of Medicare, Medicaid, and commercial payor enrollment and billing requirements.
Experience in analysis and in advising on regulatory requirements.
Experience as liaison and in coordinating activities between departments and functions and with various regulatory agencies.
Competency with Microsoft products (Project, Access, Visio, PowerPoint, Outlook, Excel, Word), web technologies and database tools, and willingness to learn new technologies when presented.
The Office of Healthcare Compliance manages VUMCâs compliance program. Our office mission is to ensure and promote the highest standards of business ethics. VUMC is committed to complying with all federal and state laws, rules, and regulations. Specifically, our office is tasked with:
Preventing any accidental or intentional violations of law
Detecting violations if they occur
Immediately taking corrective measures if violations occur
Locatedin Nashville, Tennessee, and operating at a global crossroads of teaching,discovery and patient care, VUMC is a community of individuals whocome to work each day with the simple aim of changing the world. It is a placewhere your expertise will be valued, your knowledge expanded and your abilitieschallenged. It is a place where your diversity â of culture, thinking, learningand leading â is sought and celebrated. It is a place where employees know theyare part of something that is bigger than themselves, take exceptional pride intheir work and never settle for what was good enough yesterday. Vanderbiltâs mission is to advancehealth and wellness through preeminent programs in patient care, education, andresearch.
Because weare committed to providing the best in patient care, education and research, weare proud of our recent accomplishments:
Â·US News & World Report: #1 Hospital inTennessee, #1 Health Care Provider in Nashville, #1 Audiology (Bill Wilkerson Center), 9 adult and 9pediatric clinical specialties ranked among the nation's best, #15 Educationand Training
Â·Truven Health Analytics: among the top 100hospitals in the US
Â·Becker's Hospital Review: one of the"100 Greatest Hospitals in America"
Â·The Leapfrog Group: grade"A" in Hospital Safety Score
Â·National Institutes of Health: among the top 10grant awardees for medical research in the US
Â·American Association for the Advancement ofScience: 12 facultymembers elected fellows in 2014
Â·Magnet Recognition Program: Vanderbilt nursesare the only group honored in Middle Tennessee
Â·Nashville Business Journal: MiddleTennessee's healthiest employer
Â·American Hospital Association: among the 100"Most Wired" medical systems in the US
Vanderbilt University Medical Center is a comprehensive health care facility dedicated to patient care, research, and biomedical education. Our reputation for excellence in these areas has made us a major center for patient referrals from throughout the Mid-South. Each year, people throughout Tennessee and the Southeast choose Vanderbilt University Medical Center for their health care because of our leadership in medical science and our dedication to treating patients with dignity and compassion.The mission of Vanderbilt University Medical Center is to advance health and wellness through preeminent programs in patient care, education, and research.