Under the general direction and supervision of the Vanderbilt University Medical Center Chief Compliance Officer, the Affiliates Compliance Officer works directly with the Vanderbilt University Medical Center Office of Healthcare Compliance (VUMC OHCC) and with the entity leadership teams of Vanderbilt Wilson County Hospital (VWCH), Vanderbilt Health System (VHS) and the VHS Affiliates to maintain and continuously improve effective compliance programs to prevent and detect potential regulatory compliance problems while partnering with leadership to increase overall efficiency and effectiveness of clinical, financial and administrative operations. The Affiliates Compliance Officer will be responsible for the oversight of and guidance related to federal and state regulatory and payment requirements and private contracting issues relevant to the prevention and/or detection of fraud, waste and abuse by the assigned entities and their employees and agents.
Consultation. Represent the compliance function in advice to VHS and VWCH leadership and process improvement analysis
Knowledge. Maintain extensive and current knowledge of health care compliance in the areas of health care laws, regulations, processes, systems, documentation and billing, including requirements and regulations that pertain to the Medicare and Medicaid programs, the Physician Sell-Referral (Stark) law, the federal Antikickback statute, the federal Civil False Claims Act and the Health Insurance Portability and Accountability Act (HIPAA) privacy rules.
Policy Development. Coordinate groups and functions to develop and maintain effective and clear policy and procedure applicable to VWCH, VHS and VHS Affiliates
Internal Controls. Review and recommend controls and processes implemented by employees and systems to verify appropriate operations
Inquiries. Lead investigations into allegations of errors or process improprieties within the entity
Liaison. Direct and monitor the compliance efforts of VWCH and VHS Affiliate-designated Compliance Officers. Serve as a liaison between external regulatory auditors and reviewers and the assigned entities
Collaboration. Facilitate communication among the VUMC OHCC, VWCH, VHS and the VHS Affiliates with respect to other compliance functions, such as education and auditing & monitoring, to minimize regulatory risk and maximize clinical, financial and administrative efficiency
At least 10 years relevant experience as a Corporate Compliance or Ethics Officer, health care attorney or equivalent
A CPA, Internal Audit Certification, Professional Coding Certification or Juris Doctor.
Certification in Healthcare Compliance (CHC)
Knowledge of the Compliance risks associated with a broad array of health care entities including, but not limited to, Home Health Agencies, Teaching Hospitals, Community Hospitals, Physician Groups, Ambulatory Surgery Centers, Imaging Centers, Accountable Care Organizations, and Clinical Laboratories
Prior experience working with state and federal regulatory and law enforcement agencies to resolve Compliance disputes successfully
Prior experience with federal antitrust laws, regulations and principles
Prior management supervisory experience
Excellent organizational skills
Demonstrated ability to plan, manage and work independently on large projects and initiatives
Occasional: Sitting: Remaining in seated position, Standing: Remaining on one's feet without moving., Walking: Moving about on foot., Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another, Push/Pull: Exerting force to move objects away from or toward., Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles, Reaching below shoulders: Extending arms in any direction below shoulders., Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.
Occasional: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.
Frequent: Noise: May include exposure to occupational noise levels which equal or exceed an 8-hr time-weighted average of 85 decibels, requiring enrollment in VUMC's Hearing Conservation Program which includes training, use of hearing protection, and periodic audiometry.
Continuous: Communication: Expressing or exchanging written/verbal/electronic information.
Vanderbilt University Medical Center is an Equal Opportunity Employer and adheres to the parameters of Section 504 of the Rehabilitation Act of 1973. In compliance with the Americans with Disabilities Act as amended, we will provide reasonable accommodations to qualified individuals with disabilities and encourage both prospective and current employees to discuss potential reasonable accommodations with us.
Internal Number: 2000416
About Vanderbilt Health
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As th...e largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.