Accreditation Standards, Acute Care, Analysis Skills, Artificial Intelligence (AI), Billing, Communication Skills, Corrective Action, Due Diligence, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Administration, Healthcare Reimbursement, Home Care, Interpret Regulations, LCD (Liquid Crystal Display), Leadership, Legal, Maintain Compliance, Medicare, Mergers and Acquisitions, NNCDS - Nortel Networks Certified Design Specialist, Organizational Skills, Policy Implementation, Product/Service Launch, Project/Program Management, Regulations, Regulatory Compliance, Regulatory Requirements, Respiratory Nursing, Respiratory Therapy, Risk Analysis, State Laws and Regulations, Team Player, Vendor/Supplier Management
Essential Roles and Responsibilities
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
- Lead the organization's regulatory affairs program for HME/DMEPOS operations across all markets
- Monitor, interpret and implement changes to Licensure as it relates to Medicare and other state regulatory requirements
- Oversee PECOS enrollment, NPI Registry, organization licensure and regulatory research to ensure uninterrupted billing privileges
- Ensure compliance with DMEPOS Supplier Standards, Medicare regulations and accreditation requirements
- Collaborate with Legal, Compliance, Revenue Cycle, Credentialing, Clinical Operations and Executive Leadership to identify regulatory risks and implement corrective actions
- Provide regulatory guidance for licensure as it relates to the shipment of products to organization locations
- Support mergers, acquisitions and new market expansion by managing regulatory due diligence, licensure and enrollment activities
- Develop and maintain regulatory policies, procedures and internal controls while educating leaders on regulatory changes and compliance expectations
Qualifications
- Associate degree in Healthcare Administration, Business, Nursing, Respiratory Therapy, Legal Studies or a related field preferred
- Minimum of eight (8) years of progressive experience in healthcare regulatory affairs, compliance, provider enrollment, reimbursement or healthcare legal operations
- Minimum of five (5) years of experience within the HME, DMEPOS, home respiratory, home health or post-acute healthcare industry
- Experience managing Medicare supplier enrollment, state licensure, accreditation and multi-state regulatory compliance
Preferred Knowledge, Skills and Abilities
- Extensive knowledge of PECOS, NPPES/NPI Registry
- Working knowledge of LCDs, NCDs, HIPAA, OIG Compliance
- Experience with accreditation organizations, including HQAA, ACHC and Joint Commission
- Strong analytical, organizational and project management skills with the ability to interpret complex regulations and implement operational solutions
- Excellent communication and relationship-building skills with experience collaborating across legal, compliance, operations, revenue cycle and executive leadership
You will be expected to work during normal business hours, which are Monday through Friday, 8:00 a.m. to 5:00 p.m. Please note this job description is not designed to cover and/or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Essential duties and responsibilities may change at any time, with or without notice.
We are an equal opportunity employer and all qualified applicants will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other characteristic protected by law.
By submitting your application and participating in the interview process, you acknowledge and consent that interviews, video meetings, phone screenings, and other recruiting interactions may be recorded for evaluation, training, quality assurance, compliance, and hiring purposes. These recordings may be reviewed by authorized company personnel and may be processed using artificial intelligence or automated tools to assist with notetaking, transcription, scheduling, candidate evaluation support, and other recruiting functions. No employment decision will be based on automated processing. By submitting an application and participating in the interview process, you acknowledge and consent to the recording and processing in accordance with applicable laws and company privacy policies.