Hospital Compliance Officer

About Us

Emerus is the nation’s first and largest operator of small-format hospitals, also known as community or neighborhood hospitals. Emerus’ leading national health system partners include Allegheny Health Network, Ascension, Baptist Health System, Baylor, Scott & White Health, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS and MultiCare. Our state-of-the-art hospitals are fully accredited and provide highly individualized care. From the moment a patient walks through the door, a team of exceptional medical professionals takes charge, treating patients with speed, compassion and expertise. Emerus’ distinctive level of care earned the Guardian of Excellence Award for Superior Patient Experience in six of the past seven years. More information is available at www.emerus.com.

Position Overview

The purpose of this position is to implement, administer and oversee an effective regional compliance program to prevent illegal, unethical, or improper conduct, ensuring that Emerus complies with regulatory and legal requirements and the organization’s internal policies and procedures. The Hospital Compliance Officer will report to the Chief Compliance Officer and collaboratively work closely with the Market Chief Executive Officer in the regions assigned to support.

Essential Job Functions

• Provide Compliance Program Reports to the Subsidiary Governing Board on a semi-annual basis
• Develop report and dashboards that help management and the Board evaluate the effectiveness of the program as well as mitigate potential risks and provide an objective and independent compliance function to the organization
• Raising and escalating, as necessary, significant compliance issues and protecting confidential information obtained in the course of professional activities unless disclosure of such information is required by law, applicable regulation, or organizational policy, or if maintaining the confidentiality of such information would create an appreciable health or safety risk
• Schedule regular meetings with market leadership and staff, in order to ensure the presence and use of a planned, systematic approach to identify, prioritize and assess appropriate compliance related activities
• Chair the market level Hospital Compliance Committee, Provide market level reporting for the Audit & Compliance Committee
• Identification and design of compliance program initiatives as well as the assessment of progress, by assuming an active, involved role with all hospital leaders and staff and meeting with leadership and/or staff in the hospital locations on a regular basis
• Ensure that education and in-service training on various aspects of regulatory compliance is provided to all hospital leaders and staff
• Use manuals and guidelines, prepare, monitor, lead, and ensure organizational compliance with applicable standards, licensing and certification requirements, and directives promulgated by the organization
• Lead support role in State and Federal surveys and conducting mock surveys for readiness for initial licensure or complaints as well as assist facility leadership in preparing and sustaining accreditation
• Craft and track (as needed) corrective action plans for completion and conduct follow-up sessions with management as appropriate to foster successful completion and achieve compliance
• Develop periodic reports of auditing and monitoring activities, findings, risk levels, recommendations, status or corrective action plans, and outcomes
• Collaborate with appropriate personnel for the development, review and implementation of compliance-related policies, procedures, educational initiatives or workflows relating to clinical, billing, coding or other business activities pertinent to the Compliance Program and the needs of the organization
• Conduct and/or assist with investigations of reported or identified allegation of violations
• Assist in drafting self-reporting disclosure letters to government agencies and/or managed care payors
• Coordinate or complete, as required, regulatory compliance, accreditation, performance improvement and risk management internal audits with departments within the organization – using best practices within the field – in order to comply with standards from State, Federal and Regulatory Agencies
• Participate in internal compliance audits and assist in interpreting audit findings, preparing and completing audit responses
• Provide guidance and direction to personnel regarding health care laws and regulations, including but not limited to CMS CoPs, EMTALA, Anti-Kickback, Stark Law, HIPAA and NIAHO standard regulations

Other Job Functions

• Attend staff meetings or other company sponsored or mandated meetings as required
• 35-40% Travel to facility locations as required
• Perform additional duties as assigned

Basic Qualifications

• Bachelor’s Degree in Science or Business, preferably in a healthcare related field
• 3 years of Hospital Compliance Program experience
• CHC, CHPC, or CHRC required
• CPC, CPC-H, CCS, RHIT, or RHIA preferred
• Proficiency with Microsoft Office (Excel, Word, PowerPoint and Outlook)
• Billing and Coding experience using CPT, ICD-9/ICD-10 and HCPCS codes in an Emergency Medicine and Hospital environment, a plus
• ICD-10 Training, a plus