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About the Role

The Director of Risk Management and Corporate Compliance (DRMCC) oversees the organization’s Risk Management and Corporate Compliance programs. This role functions as an independent and objective body that reviews and evaluates compliance issues and concerns within the organization, ensuring adherence to regulatory requirements, company policies, and ethical standards. The position also leads efforts to minimize organizational risk and potential liability.

Responsibilities

• Remains current on the healthcare market and provides proactive analysis of organizational areas.
• Stays current on best practices regarding regulatory and accreditation compliance, and healthcare delivery trends.
• Implements and sustains an education process for staff on Regulatory mandates, Risk Management, HIPAA, and Corporate Compliance.
• Develops and executes the annual Risk Management Plan.
• Oversees the organization-wide Risk Management program, including electronic database and incident reporting.
• Provides a process for reporting and managing claims and lawsuits in compliance with the Federal Tort Claims Act (FTCA).
• Completes the required annual Redeeming application for FTCA coverage.
• Serves as the lead representative to FTCA and commercial market professional liability insurers.
• Reviews current policies and procedures and proposes changes.
• Receives, reviews, trends, and analyzes incident reports and takes appropriate action.
• Presents incident summaries to relevant committees and external regulatory agencies.
• Conducts root cause analysis as appropriate.
• Assists in peer review activities.
• Ensures corrective actions are implemented and reports are provided to regulatory agencies.
• Leads the patient complaint process for follow-up and investigations.
• Develops the annual Compliance Plan for approval by the Board of Directors.
• Ensures compliance with all State and Federal regulations, including OMIG, OIG, and SAMS exclusion monitoring.
• Participates in network-wide preparation for regulatory surveys.
• Ensures departments are complying with various rules and regulations.
• Maintains current knowledge of corporate compliance programs, policies, and legal opinions.
• Develops corporate compliance policies and procedures.
• Collects and investigates potential corporate compliance submissions and enforces the non-intimidation/non-retaliation policy.
• Prepares and reports compliance issues to leadership and regulatory authorities.
• Conducts or designates corporate compliance audits.
• Creates, leads, and executes training for boundaries in healthcare and ethics expectations.
• Works with Chief Talent Officer on provider credentialing and privileging.
• Provides consultation on vendor contracts and other agreements.
• Demonstrates excellence in customer service.
• Communicates HIPAA compliance, corporate compliance, and client confidentiality.
• Ensures compliance with local, state, and federal regulations.
• Adheres to the National Patient Safety Goals.
• Develops and manages compliance and risk management content for the Learning Management System (LMS).
• Completes other duties as assigned.

Requirements

• Bachelor’s Degree in Health or Human Services.
• Minimum of 10 years’ experience in a healthcare setting.
• Includes leadership experience.
• Demonstrated knowledge of operational, financial, quality improvement, risk management, and human resource procedures and regulations.
• At least 5 years of supervisory experience.

Skills

• Risk Management
• Corporate Compliance
• HIPAA
• Federal Tort Claims Act (FTCA)
• Root Cause Analysis
• Peer Review
• Regulatory Compliance
• Auditing
• Training Development
• Customer Service
• Client Confidentiality

Location

• Onsite

Work Type

• Full-time

Experience Level

• Director
• 10+ years experience
• 5+ years supervisory experience

Education Level

• Bachelor's Degree
• Master's Degree (Preferred)
• Certification in Healthcare Compliance (CHC) (Preferred)

Salary/Compensations

• $100,000 - $115,000 annually

Equal Opportunity

• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.