Sr. Compliance Investigation Consultant
The Senior Compliance Investigations Consultant is responsible for effectively carrying out investigations of internal and external reports of compliance-related allegations.
• A bachelor's degree is required, master's degree preferred.
• Must have six (6) years' experience in healthcare compliance, preferably with a large, multi-faceted
healthcare company or academic medical center. Experience with compliance investigations,
confidential communications, attorney-directed reviews, conflicts of interest, employee relations and
other healthcare compliance-related activities required.
• Prior experience in revenue cycle operations preferred, such as coding, billing, collections, account
reconciliation or other patient financial services functions.
Equivalent Education and/or Experience
• An equivalent combination of experience and certification may be accepted in lieu of education only.
• Certification in a healthcare compliance-related specialty is required. Must be currently certified and
in good standing with one of the following:
• Certified in Healthcare Compliance (CHC)
• Certified Compliance and Ethics Professional (CCEP)
• Certified in Healthcare Privacy Compliance (CHPC)
• Certified in Healthcare Research Compliance (CHRC)
• Certified Professional Compliance Officer (CPCO)
• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Inpatient Coder (CIC)
• Certified Coding Specialist (CCS)
Skills or Special Abilities
• Detailed knowledge of compliance program requirements for hospitals and academic health systems.
• Demonstrates the ability to evaluate healthcare compliance issues and make appropriate
• Adept at developing and executing all phases of a plan of audit and compliance investigations,
including but not limited, to review and analysis of data, information and records, conducting reviews,
and drafting findings and conclusions.
• Able to write clear, detailed reports summarizing the scope of a purpose of audits and compliance
investigations, conclusions or findings and the application of the compliance risk analysis and
corrective action recommendations.
• Strong oral and written communication skills and interpersonal skills. Able to communicate thoughts,
ideas, information and messages with clear language, style, organization and format appropriate to
the subject matter, purpose and audience.
• An active listener with the exercise of sound professional judgement.
• Possesses excellent critical thinking skills, including the ability to identify a problem, determine the
root cause, communicate findings and participate in the development of the solution.
• Detailed-oriented with strong organizational and time management skills and the ability to effectively
prioritize daily tasks.
• Capable of managing difficult conversations with sensitivity and the ability to respond to confidential
information with objectivity and discretion.
• Demonstrates a high degree of integrity and practice ethical standards.
1. Independently and objectively conducts investigations of compliance and ethics related matters
across all business areas.
2. Processes and evaluates allegations to facilitate decisions related to the scope and execution of an
3. Researches and reviews suspected activities to develop factual evidence.
4. Identifies, collects, and analyzes factual evidence to establish clear and concise findings to facilitate
5. Conducts in-person interviews and documents discussions in a reliable and consistent fashion.
6. Drafts comprehensive investigations reports that clearly and concisely summarizes the nature of
concern and substantiates or negates allegations of misconduct or non-compliance.
7. Informs leadership of potential or actual allegations and recommends corrective action or
8. Assists with routine administrative and technical aspects of investigations.
9. Works effectively with the Office of Talent Management and the Legal Department.
10. Assists with the maintenance of the sanction screening database tool, coordinates scheduled searches
for excluding individuals, assists with the resolution process and summarizes findings.
11. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines pertaining to
healthcare compliance and ethics. Seeks advice and guidance as needed to ensure proper
12. Serves as an advocate for compliance and ethics and champions the importance of compliance with
laws, regulations, policies and procedures in an effort to build a culture of compliance and integrity.
13. Consistently serves as a resource for Parkland employees, developing collaborative working
relationships and providing timely advice related to compliance and ethics matters.
14. Stays abreast of the latest developments, advancements, and trends in the field of data management
and compliance and ethics by attending seminars/workshops, reading professional journals, actively
participating in professional organizations, and/or maintaining certification or licensure. Integrates
knowledge gained into current work practices
15. Identifies ways to improve work processes and improve customer satisfaction. Makes
recommendations to supervisor, implements, and monitors results as appropriate in support of the
overall goals of the department and Parkland.
1. Identifies ways to improve work processes and improve customer satisfaction. Makes
recommendations to supervisor, implements, and monitors results as appropriate in support of
the overall goals of the department and Parkland.
2. Stays abreast of the latest developments, advancements, and trends in the field by attending
seminars/workshops, reading professional journals, actively participating in professional
organizations, and/or maintaining certification or licensure. Integrates knowledge gained into
current work practices.
3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact
the area. Develops effective internal controls designed to promote adherence with applicable
laws, accreditation agency requirements, and federal, state, and private health plans. Seeks
advice and guidance as needed to ensure proper understanding.
- Due Diligence