The Executive Director of Compliance Services is responsible for the direction and leadership of operational, financial, programmatic and personnel activities for the facility, professional, and privacy compliance programs for Cone Health. This includes establishing, meeting and continuously monitoring the goals and objectives of the compliance program while maintaining alignment with the strategic goals and objectives for Cone Health. The range of duties and responsibilities is broad and varied, the position's major responsibility is directing the day-to-day operations, budgeting, financial management, and human resource management for the Cone Health compliance functions.
The Executive Director of Compliance Services works closely with a variety of stakeholders, coordinating the activities of compliance and privacy across the Cone Health enterprise.
Additionally, this position will serve as the Cone Health Privacy Officer. This role is responsible for assistance with policy development and implementation of processes and programs covering the privacy of, and access to, patient health information in compliance with federal and state laws.
The Executive Director of Compliance Services reports directly to the Chief Compliance and Privacy Officer of Cone Health. Direct reports to the Executive Director of Compliance Services are the Privacy Program Manager, Director of Hospital Compliance Services, and Director of Professional Compliance Services.

 

 

 Compliance Program Duties
Maintains and implements a comprehensive enterprise-wide compliance program which ensures compliance with federal and state billing regulations and the Department of Health and Human Services (HHS) Office of Inspector General's (OIG) Compliance Program Guidance.
Implements processes, procedures, and structures to maintain a current, active, and effective Compliance Program.
Collaborates with key management associates, key departments and committees and the compliance and privacy teams, as necessary, to ensure compliance with applicable laws and regulations and be consistent with the Cone Health's Compliance Program.
Collaborates with Legal Services, the Vice President and Chief Compliance and Privacy Officer and compliance and privacy teams to ensure proper reporting of violations to enforcement agencies as appropriate or required, as directed by the Vice President and Chief Compliance Officer.
Ensures processes and procedures are in place to maintain consistency of the Compliance Program within the overall Cone Health direction to include consistent application of sanctions for failure to comply with compliance policies and procedures for all individuals in the region's workforce, extended workforce and for all business associates, in cooperation with Human Resources and Administration Teams, as applicable.
Manages the HelpLine reporting and ensures issues are investigated, addressed, and closed timely.
Ensures work plan activities are completed monthly and that any associated Corrective Action Plans (CAP's) are implemented, tracked, and closed timely
Presents work plan activities in conjunction with the associated compliance team member to the applicable compliance committee and the Corporate Compliance Team.
Acts as an independent review and evaluation body to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated, and resolved.
Leads non-compliant issue resolution activities and corrective action. Any non-compliant issue will be coordinated through the appropriate Compliance Team for resolution.
Collaborates with applicable Departmental Directors/Managers during visits from regulatory agencies, as necessary, to assist in the collection of information and ensures complete and accurate documentation of the proceedings and then report all things back to the Compliance Team.
Periodically reviews the Code of Conduct and Compliance Program and collaborates with the Human Resources Team to provide compliance education. Ensures knowledge and region-wide distribution of the Code of Conduct.
Oversees the conflicts of interest disclosure and management program.
Oversees the physician payment and agreement review process and escalates issues as necessary.
Plans and directs periodic meetings with hospital staff to enhance knowledge, address issues, share information to enhance an effective compliance program, and foster the growth of an integrity-based culture.
Performing the annual risk assessment and developing work plans in coordination and collaboration with department leadership.
Supports and guides preliminary planning and establishes direction for audits and investigations. Provides leadership to assigned auditors/investigators, manages project outcomes while meeting established milestones and deadlines.
Manages projects and maintains appropriate workflow prioritization.
Oversees compliance and privacy teams and reviews work papers and reports for adequacy of content and accuracy of conclusions and recommendations. Provides status updates to Chief Compliance and Privacy Officer and coordinates Chief Compliance and Privacy Officer reviews and follow-up of questions/concerns.
Monitors key performance indicators for department performance and compliance with policies and procedures.
Reviews industry, trade and regulatory publications for regulation, policy and enforcement changes, and coordinates compliance and audit activities across Cone Health.
Performs other related duties and manages other projects incidental to the work described herein.
Privacy Program Duties
Acts as the Privacy Officer for Cone Health.
Provides leadership support to Privacy Manager and maintains an active and effective HIPAA compliance program.
Coordinates all Privacy concerns with the Vice President and Chief Compliance and Privacy Officer.
Maintains current knowledge of applicable federal and state privacy laws and accreditation standards and monitors advancements in information privacy technologies and requirements to ensure organizational adaptation and compliance.
Resource Manager
Creates and maintains a satisfying workplace that fosters professional growth and job satisfaction for all members of the compliance and privacy teams.
Interviews to select top talent, matching compliance and privacy program needs with appropriate skill sets.
Coaches and mentorss compliance and privacy team members by providing clear direction and priorities, timely review and feedback on documentation and engagement progress, and facilitate effective communication throughout engagements.
Works with team members to set goals and responsibilities for specific engagements, fosters teamwork, facilitates discussions on new ideas and opportunities for adding value to the department and the organization.
Develops and implements recruitment and retention strategies that support a culture of leadership.
Identifies and addresses own professional growth needs.
Assesses manager and staff development needs, identifies goals and provides resources.
Coordinates knowledge sharing amongst the compliance and privacy teams.
Identifies lack of competency in performance and establishes a plan which includes goals, interventions, and measures.
Maintains membership in professional organization(s) to develop knowledge and resources through networking, continuing education, and participation in national, regional, and/or local activities.
Ensures integration of ethical standards and core values into everyday work activities.
Departmental Leader
Incorporates Cone Health's vision, missions and values in goals and programs within the compliance and privacy functions.
Develops and manages operational initiatives with measurable outcomes.
Formulates objectives, goals, and strategies collaboratively with other stakeholders.
Prepares and delivers reports to operational leadership outlining progress toward meeting annual goals and objectives, to include performance.
Critical Interfaces
Leads and/or serves on a variety of appropriate internal and external committees to represent Cone Health and the compliance and privacy programs.
Serves as a representative of Compliance and Privacy Services leadership to Cone Health to facilitate the shared interests and relationship between the parties.
Maintains a strong client service focus by developing productive working relationships and regular communication with key stakeholders across the organization.
Fosters a consultative role with management and client personnel.
Participates and partners with clients on advisory groups or steering committees.

 

EDUCATION:Required
Bachelors Degree in business/health care related field 
Preferred
Masters degree in business/health care related field, CPA or JD preferred.

 

EXPERIENCE:Required
Seven years demonstrated experience leading health care regulatory and compliance functions.
Preferred
Previous compliance leadership role in a mid-sized to large or complex health care setting.

 

LICENSURE/CERTIFICATION/REGISTRY/LISTING:Required
CHC
Preferred
CHRC, CHPS
Equal Opportunity Employer At Cone Health, we strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of their race, religion, age, sex, sexual orientation, gender identity, veteran's status, ethnicity, national origin, disability, color, or any other characteristic protected by law. Our hiring and employment choices are based on each individual's qualifications, skills and performance. We believe that by embracing the diversity of our team, we can better serve our patients, communities and each other.