Director of Risk and Compliance

Job Summary :

The Director oversees the Clinic Compliance Program and is responsible for developing, planning, organizing, and directing all functional activities related to the clinic's patient safety and risk programs. Functioning as an independent and objective body, this position reviews and evaluates compliance issues and concerns within the organization to ensure the Board of Directors, management, and employees are in compliance with rules and regulations of regulatory agencies, company policies and procedures are followed, and behavior in the organization meets the company's Standards of Conduct.

Essential Functions and Responsibilities:

• Develops, initiates, maintains, and revises policies and procedures for the Compliance Program and related activities (HIPAA Privacy).
• Manages day-to-day operation of the Compliance and Risk Management Programs.
• Develops and periodically reviews and updates the clinic's Standards of Conduct.
• Collaborates with other departments to direct compliance issues to appropriate existing channels for investigation and resolution.
• Responds to alleged violations of rules, regulations, policies, and procedures related to compliance issues and Standards of Conduct by recommending or initiating investigation procedures and develops and oversees a system for uniform handling of such violations
• Acts as an independent review and evaluation resource to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated, and resolved.
• Identifies potential areas of compliance vulnerability and risk through auditing and monitoring; develops and implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future.
• Consults with legal counsel and insurance carriers on matters involving clinic risk and liability determine whether a claim should be paid, litigated, or denied.
• Coordinate and oversee medical peer-review process on issues related to standard of care.
• Promotes and ensures risk and patient safety program integrity through adequate oversight of staff functions, data collection and reporting.
• Responsible for maintaining and monitoring the incidents and claims reporting system.
• Staffs the clinic's Compliance Committee and leads the Clinic Safety Committee.
• Educates, advises and counsels on relevant patient safety and risk management issues affecting the organization.
• Participates in professional development efforts to ensure appropriate application of current health care practices and trends
• Works with the Human Resourced Department and others as appropriate to develop an effective compliance training program, including appropriate training for new employees as well as ongoing training for all employees and managers.
• Institutes and maintains an effective compliance communication program for organization, including promoting heightened awareness of Standards of Conduct, and understanding of new and existing compliance issues and related policies and procedures.
• Performs other duties that may be assigned from time to time.

Performance Measurements:

• Stay current of regulation changes in regard to HIPAA and OSHA.
• Perform all duties with accuracy and extreme attention to detail to limit errors.
• Employ exceptional customer service and communication skills with external and internal customers.
• Comply with all Clinic guidelines and policies.

Knowledge and Skills:

Experience:

• Two years of experience in a healthcare or administrative role or one year experience management/supervisory experience.

Education:

• Bachelor's degree is preferred. Associate's degree required.
• Prefer active RN licensure by the Kansas Board of Nursing, or a Multi-state compact license.

Physical Requirements:

• Requires normal range of vision and hearing and manual dexterity sufficient to operate a keyboard, telephone and other office equipment as needed.
• Requires full range of body motion.
• Requires sitting for extensive periods of time.

Other skills:

• Demonstrate ability to deal with conflict in a professional manner.
• Possess excellent verbal and written communication as well as excellent interpersonal skills with patients, staff, and other health care professionals.
• Demonstrates ability to prioritize workload, with the ability to juggle several projects at one time.
• Critical problem-solving ability with the ability to make decisions in information available, which is not always black and white.
• Self-motivated with a commitment and enthusiasm for compliance and ethics.
• Organizational - proactively prioritizes risk and compliance needs and effectively manages resources.
• Leadership - guides individuals and groups towards desired outcomes
• Computer Skills- demonstrates proficiency in Microsoft Office, and the ability to navigate an EMR system and other applications as required with minimal training.
• Policies and Procedures- articulates knowledge and understanding of organizational policies, procedures, and systems