Chief Compliance Officer

About The Villages Health

The Villages Health is a patient-centered primary care driven, multi-specialty medical group with over 800 team members. Our unique care model gives us both the time and resources to truly care for our patients, along with a company culture that supports a healthy work-life balance for our team members. Our purpose, mission and vision is to empower Villagers and the surrounding communities to live out their dreams by keeping them healthy and healing them quickly. Together, we are changing the way healthcare is delivered and are making a positive difference in the lives of our patients and the communities we serve. In doing so, The Villages Health is creating America’s Healthiest Hometown.

Our Full-time Benefits

Medical, Dental & Vision Insurance | Matching HSA & 401k | PTO & Paid Holidays | The Villages Charter School Eligibility | & much more!

Responsibilities:

The Chief Compliance Officer (“CCO”) shall be responsible for leading, overseeing, and managing The Villages Health’s (TVH) Compliance Program and all affiliated programs. The CCO shall ensure the overall effective operations of TVH’s Compliance Program and will coordinate efforts across the organization including, but not limited to, enterprise leadership, the clinical practice level, and the physician level. The CCO shall be a full-time employee, reporting directly to TVH’s Chief Executive Officer (“CEO”) and to TVH’s Board of Directors.

Essential Duties and Responsibilities:

The CCO’s responsibilities include, but are not limited to, the following:

• Developing, updating, and implementing Compliance Policies and Procedures (“P&Ps”) and supporting protocols required to maintain compliance with all federal and state healthcare program requirements, health plan contracts, and accreditation requirements
• Reviewing and revising TVH’s Standards of Conduct, Compliance P&Ps, and processes, as necessary, to stay abreast with evolving healthcare statutes, regulations, and industry leading practices.
• Conducting an annual, comprehensive Compliance Risk Assessment that informs the annual Compliance Work Plan and is presented to TVH’s Board of Directors and designated leadership for review and approval.
• Carrying out effective routine auditing and monitoring protocols in alignment with the Compliance Work Plan.
• Ensuring all staff, including physicians and coders, receive appropriate compliance education and training, including training on general compliance, fraud, waste, and abuse (FWA), HIPAA Privacy & Security, and coding and billing compliance.
• Instituting effective lines of communication and ensuring prompt response and resolution to reported compliance issues, concerns, or questions raised by staff, patients, and the public.
• Serving as Chair of the TVH’s Corporate Compliance Committee, facilitating at least quarterly meetings and reporting to the committee in alignment with regulations and industry leading practices.
• Reporting to TVH’s Board of Directors on at least a quarterly basis, or more frequently as needed, and providing Compliance Program updates in alignment with regulations and industry leading practices.
• In partnership with TVH Human Resources, ensuring that required credentialing and federal and state exclusion checks are performed on applicable staff in alignment with federal and state regulations and industry leading practices.
• Coordinating and executing on TVH’s response to any governmental requests, subpoenas, inquiries, or investigations.
• Developing formal protocols for managing compliance violations, including the development and implementation of corrective action plans and enforcing disciplinary actions in partnership with TVH Human Resources, where applicable.
• Collaborating with TVH’s internal legal counsel and outside counsel, as necessary, to address any legal matters or concerns.
• Fostering a culture of ethical behavior and collaboratively partnering with all department leaders to integrate compliance into TVH business practices.
  
  

Education/Experience Requirements:

• At least 10 years of experience with healthcare compliance programs, preferably with large physician practices contracted with Medicare Advantage.
• Bachelor’s degree from an accredited college.
• Master’s degree in business administration, health care administration, a juris doctorate, or related education preferred.
• Certification in Healthcare Compliance (CHC), Healthcare Privacy Compliance (CHPC), Health Care Compliance Association (HCCA) membership, and/or course accreditation from HCCA or similar organization preferred.
• Knowledge of regulatory requirements and industry leading practices for compliance programs. This includes knowledge of the seven elements of compliance, as required by the OIG and other regulatory agencies, and hands-on experience with leading and successfully implementing and managing effective compliance programs.
• Knowledge of risk adjustment rules, regulations, and guidance.
• Knowledge of physician incentive and compensation programs.
• Knowledge of HIPAA Privacy & Security, including practical application within a healthcare organization.
• Knowledge and practical application of the healthcare fraud and abuse laws, rules, and regulations, including the Anti-Kickback Law, the Stark Law, the False Claims Act (as related to documentation, coding, and billing), and applicable Florida state regulations
• Excellent communication and analytical skills.
• Ability to seamlessly work in complex environments, including interacting with senior-level executives, physicians, clinical/non-clinical support staff, operations, and administrative staff.
• The CCO will lead and mentor TVH’s Compliance team, ensuring adherence to regulatory requirements and alignment with TVH’s Core Values, Code of Conduct, and TVH Policies and Procedures
  
  

Salary is commensurate with experience.

Questions?Contact us at recruitment@thevillageshealth.com

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