Responsible for overseeing the administration of the Compliance Program for the Foundation of the Massachusetts Eye and Ear Infirmary, Inc. and all of its subsidiaries (hereinafter referred to as “Mass. Eye and Ear”). Reports to the General Counsel with as needed access to the President and CEO and regular reports to the Board Audit and Compliance Committee. Manages Compliance Department staff.
1. Oversees Mass. Eye and Ear’s Compliance Program; including without limitation the development, ongoing review and revision of policies, procedures and training materials; performance of periodic risk assessments; and the conduct of auditing and monitoring functions.
2. Chairs the Management Compliance Committee.
3. Develops the annual Compliance Work Plan.
4. Coordinates and participates in a multifaceted compliance education program and periodically evaluates the effectiveness of the training.
5. Conducts and/or supervises Compliance Department staff in the performance of prompt, appropriate and consistent investigations of alleged violations of policies and procedures, working closely with appropriate individuals throughout the organization, and implements corrective action plans for resolution of problematic issues.
6. Collaborates with management to facilitate the establishment of department-level policies, procedures, processes, training and audits as appropriate to embed compliance and privacy requirements into daily operations.
7. Continuously monitors and prioritizes program activities in light of regulatory updates, changes in the organization’s needs or services, and revisions to payor policies.
8. Works closely and collaboratively with the Office of the General Counsel and the Information Security Officer.
9. Works closely with internal and external auditors, and coordinates with external regulatory agencies on a timely basis.
10. Manages the Compliance Hotline, a confidential communication mechanism for employees to report a violation of any kind without fear of retaliation.
11. Hires, orients, appraises, and disciplines Compliance Department staff. Makes recommendations for merit increase amounts as part of the appraisal process.
12. Develops and manages an annual budget for the Compliance Department.
Requires a Bachelor’s degree in business, business law, health policies, or equivalent combination of education and experience. Master’s degree preferred. Must have five years of compliance management or audit experience in health care/clinical reimbursement, or equivalent and experience with compliance regulatory agencies. Certification in Healthcare Compliance (CHC) preferred.