Job Description

The Chief Compliance Officer (CCO) is responsible for developing, implementing, and overseeing Summit Healthcare’s compliance program to ensure adherence to all applicable federal, state, and local laws, regulations, and industry standards. This role requires a deep understanding of the healthcare industry, including reimbursement, coding, billing, and privacy regulations. The CCO will collaborate with leadership to foster a culture of compliance and ethical conduct. This position is responsible for working closely with the Governing Board (Board) and Administration to ensure the consistent readiness of all regulatory requirements. The CCO reports directly to the Chief Executive Officer.

Essential Functions

- Proactively reports to and educates the Board, Administration, and the management team regarding regulatory compliance and related issues, new statutes/guidelines.

- Consults with Administration, medical staff and department directors on compliance issues.

- Develops risk-based compliance testing of existing procedures and controls to identify, detect and correct noncompliance.

- Reviews and analyzes reports in relation to compliance.

- Oversees functions of the Compliance staff.

- Facilitates work process teams as requested/needed.

- Develop, implement, and maintain a comprehensive compliance program aligned with organizational goals and industry best practices.

- Stay abreast of healthcare laws, regulations, and industry standards to ensure compliance.

- Conduct regular risk assessments to identify potential compliance vulnerabilities.

- Develop and implement policies and procedures to mitigate compliance risks.

- Oversee compliance training and education programs for all employees.

- Conduct internal audits and investigations to assess compliance with laws and regulations.

- Respond to regulatory inquiries and audits in a timely and effective manner.

- Collaborate with legal counsel to address compliance-related legal issues.

- Develop and maintain effective relationships with key stakeholders, including government agencies, industry associations, and internal departments.

- Monitor industry trends and emerging compliance challenges.

- Provide leadership and guidance to the compliance team.

Other Duties

- Assists staff with developing a systematic approach to data collection, measurement, assessment, and improvement of processes.

- Participates in departmental and association wide informational meetings and inservices, including staff meetings, association wide forums, and seminars.

- Reviews department and association wide policies and procedures annually. Develops and maintains new policies and procedures as needed.

- Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Abilities

- Strong knowledge of healthcare laws, regulations and industry standards, including HIPAA, Stark, Anti-Kickback and False Claims Act.

- Proven leadership and management skills.

- Strong analytical and problem solving skills.

- Ability to work independently and as part of a team.

- Excellent communication and interpersonal skills.

- Must read, write, speak, and understand English.

Supervisory Responsibilities

- Must be proficient in the hospital time-keeping system.

- Job includes full supervisory responsibilities such as: (1) providing daily work direction, (2) approval of absences or overtime, and (3) recommendations and/or approval regarding hiring, terminations, pay changes, or job changes.

- Decisions are made within prescribed operating guidelines, hospital policy constraints, and a broad interpretation of applicable laws and governmental guidelines.

- Totally accountable for compliance department budget.

- Partially accountable for control of capital assets.

- Partially accountable for long-range operational planning.

- Partially accountable for long-range strategic planning.

Work Environment

At Summit Healthcare, our mission statement is that we are trusted to provide exceptional, compassionate care close to home. Our vision is to be the healthcare system of choice.

To uphold our mission and vision statements, we expect all employees to practice SHINE Behavioral standards:

- Always SHINE – show respect and be kind.

- Always work together – we are on the same team.

- Always serve others – no job is beneath you.

- Always maintain high standards of quality and safety – best practice every time.

- Always communicate clearly – be compassionate.

- Always practice integrity – maintain confidentiality.

- Always be accountable – take responsibility.

- Always empower – create an environment of success.

- Always excel – don’t settle for mediocrity.

- Always promote wellness – make choices for a healthy lifestyle.

Physical Demands

Exerts up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Involves sitting most of the time, but may involve walking or standing for brief periods of time. The worker is subject to substantial overtime, evening meetings, on-call status, contact with chemicals, contact with infectious fluids, heavy lifting, constant standing, extensive close work, extensive computer work, and encounters with upset/disturbed individuals.

OSHA Exposure Category:

Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues and are not a condition of employment.

This is a safety sensitive position.

Required Education and Experience

- Advanced degree in healthcare administration, nursing, law, or related field.

- Minimum 5-7 years experience in healthcare compliance.

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