Senior Corporate Compliance Specialist

Job Responsibilities

Regulatory Knowledge & Oversight - Independently interpret and analyze the concepts and principles of federal and state law, institutional policies / procedures / guidance and professional guidance as it relates to the review and oversight of regulated activities and assess the impact of specific regulatory decision issues on the overall environment at CCHMC. Lead the creation and revisions of departmental policies / procedures / guidance. Support, as an institutional corporate compliance (specifically healthcare fraud, waste, and abuse) expert, the creation and revision of institutional policies / procedures / guidance.

Compliance - Serve as an institutional expert in corporate compliance (specifically healthcare fraud, waste, and abuse) activities. Work with institutional Compliance Officers, designated compliance experts in all operational areas to continue to improve compliance processes. Conduct legal and regulatory research and prepare written documentation such as policies, procedures, and other written communication to support ongoing activities of the Compliance Program. May independently interpret & analyze the concepts & principles of government regulations & guidance. Provide education for new and existing employees on compliance issues and the Compliance Program. Develop training and communication materials. Enhance and improve audit activities to monitor compliance in identified areas. Stay current regarding compliance issues and regulations affecting health care and recommend changes as appropriate.

Teamwork, Collaboration & Leadership / Management - Work collaboratively with various teams and interface effectively with primarily internal and occasionally external stakeholders at primarily peers across the organization. Build consensus among stakeholders after more senior leaders have established priorities and gain commitment to achieve defined institutional priorities. Use basic project management and organizational skills to lead divisional / departmental initiatives. Lead project team to achieve successful outcomes through both direct and indirect leadership. May lead the development and execution of specific aspects of a regulatory and compliance program in support of the institution's strategic plan. Contribute to recommendations for solutions that maximize organizational performance. Represent CCHMC at the regional and national level disseminating best practices.

Institutional Support - Serve as a subject matter expert in assigned program area. May be called upon to provide key input, based on knowledge, experience and expertise, on institutional initiatives and programs at the direction of leadership, in order to ensure compliance with applicable federal and state regulations and statutes and CCHMC policies, principles, ethical standards and procedures.

Investigation - Conduct investigations related to corporate compliance (specifically healthcare fraud, waste, and abuse). Follow investigational procedures documenting appropriate information & outcomes. Collaborate with compliance officers, departments, & managers as needed. Implement corrective & preventative action.

Assist with operation, reporting, and analytics for the : Compliance & Integrity Helpline, Conflict of Interest Program, and Exclusion and Sanction Screening Program

Job Qualifications

Bachelor's degree in a related field 5+ years of work experience in a related job discipline (corporate compliance specifically healthcare fraud, waste, and abuse) OR Master's Degree and 3+ years of directly related experience (corporate compliance specifically healthcare fraud, waste, and abuse) Certified Healthcare Compliance (CHC) certification required (Within 24 months for outside hire)