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Legal & Compliance
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Corporate
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36871 Requisition #

Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good - from the operating room to the boardroom, we are driven by our unique passion to live God's love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.

 

We're looking for someone to join our team as a Director, Health Plan Compliance who:

Directs, oversees, monitors and implements the Health Plan Compliance Program. Assesses organizational performance and behaviors and identifies operational issues impacting compliance. Functions as the primary point of contact with external entities on compliance and privacy matters including, but not limited to, regulatory and accrediting agencies, internal/external auditors, and State and Federal agencies. Provides leadership and ongoing monitoring of the implementation and compliance with government regulations.

 

Essential Functions:

  • Develops plans, policies and process change designs to prevent, mitigate or correct identified problems. Directs investigations into all complaints/allegations. Completes timely reports/responses to State and/or Federal government investigations/inquiries or self-disclosure processes.
  • Collaborates with internal/external counsel. Assists in risk evaluation and works collaboratively with facility/entity leaders to implement, monitor and mitigate risk corrective plans as outlined by the compliance program. Leads the development and implementation of the compliance work plan, monitors milestones and implementation timelines. Monitors all compliance and privacy enforcement activities, including hotline allegations and associated disciplinary action. Audits corrective action plans, and performs investigations and reviews. Leads the development and implementation of compliance initiatives.
  • Creates and supports an organizational compliance structure which enables the organization to reasonably implement, monitor and enforce a program to prevent and detect criminal or unlawful conduct, and ensure activities relative to Medicare, Medicaid, and other government programs are conducted in a manner consistent with program requirements.
  • Leads the development and review of policies and oversees the education/training provided to employees. Identifies and responds to identified training needs for compliance team. Acts as an internal consultant to system and facility executives on privacy and compliance issues. Ensures routine compliance reporting is provided to facility and service area executives.
  • Performs other job-related duties as assigned.

 

You'll be successful with the following qualifications:

 

Education: 

  • Bachelor's Degree or equivalent combination of education/related experience: Required
  • Master's Degree: Preferred

 

Work Experience: 

  • Seven years privacy/compliance experience: Preferred
  • Five years leadership experience: Preferred

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