Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.
It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community.
Benefits Eligible
Full-Time Benefit Eligible
Work Shift
Day - 8 Hour or less Shift (United States of America)
Department
8895 Compliance Program
To direct and lead Kaweah Health's Compliance Program to facilitate effective and efficient compliance with federal and state laws and regulations.
QUALIFICATIONS
Education
Required: Bachelor's or Master's degree with emphasis in health care or in a closely related field.
Experience
Required: Minimum of five years of hospital compliance management experience.
JOB RESPONSIBILITIES
Essential
Serves as Director of Corporate Compliance for Kaweah Health and all subsidiary corporations and organizations.
Oversees the Compliance Program and privacy related activities functioning as an objective body that reviews and evaluates compliance issues/concerns within Kaweah Health. Monitors effectiveness of the Compliance Program.
Develops and maintains the Standards of Conduct and policies that support compliance program objectives and information privacy practices. Communicates the Standards of Conduct to ensure that behaviors in the organization meet the Standards to prevent illegal, unethical, or improper conduct.
Conducts/facilitates risk assessments of OIG Work Plan concerns and complete operational, financial and medical reviews to determine Kaweah Health risk of work plan issues.
Prepares quarterly reports to the Board of Directors and regular reports to the CEO, Executive Team and Compliance Committee detailing compliance initiatives and recommendations for improvement/changes in the overall Compliance Program.
Ensures that Kaweah Health does not hire, employ, contract with and/or provide medical privileges to anyone excluded from participation in Federal or State Health Care Programs.
Leads and/or supports internal compliance investigations and audits throughout Kaweah Health, including compiling detailed reports with recommendations to the Compliance Committee. Collaborates with other departments to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with the Compliance Advocate (legal counsel) as needed to resolve difficult legal compliance issues.
Acts as an independent review and evaluation body to ensure that compliance issues/concerns within Kaweah Health are being appropriately evaluated, investigated, and resolved.
Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
Institutes and maintains an effective compliance communication program for Kaweah Health. Works with outside legal counsel to establish and provide direction, management and response of the confidential reporting line. Promotes staff use of the reporting line.
Works with Human Resource Department and others as appropriate to develop an effective compliance and HIPAA patient privacy training program, including appropriate introductory and ongoing training for new employees, physicians and managers.
Provides support to other departments by researching laws and regulations, monitor changes in laws and regulations and communicate applicable changes to pertinent areas to ensure continued compliance.
Ensures that Kaweah Health maintains policies and practices on compliance with HIPAA patient privacy regulations. Works closely with applicable areas to ensure continued compliance with requirements.
Develops, monitors and investigates patient privacy concerns. Coordinates corrective actions, resolution and remediation of privacy issues.
Works with legal counsel and Administration to ensure that all physician contracts meet Medicare Fraud and Abuse, Medicare Anti-Kickback, Stark and all other regulatory standards.
Oversees and maintains the physician contracting policy and procedure. Updates the policy based on new and changing regulations as appropriate.
Serves as a resource to review other Kaweah Health contracts.
Directs, supervises and develops assigned personnel, including performance evaluations, orientation, and training.
Participates as an active member of the Compliance, Bioethics, Institutional Review Board and Quality Council Committees. Reports on project findings and completes special projects, tasks, or reviews as assigned by the Committee.
Additional
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
Pay Range
$72.90 -$109.36
If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.