Oversees the Compliance Program and provides leadership, direction and accountability related to compliance matters within the organization. Assists the Board of Trustees, management, employees, medical staff and workforce to comply with federal, state and local statutes, regulations and ordinances as well as the organization’s policies and procedures and promotes ethical behavior in the organization consistent with the Compliance Program’s Code of Conduct.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
For all Colorado West Healthcare System entities, facilitates conformance with applicable legal and regulatory requirements, including but not limited to requirements relating to Medicare and Medicaid conditions of participation and reimbursement, referral source relationships, employment and discrimination law, environmental laws, etc.
Maintains current knowledge of the organization’s legal and regulatory requirements. and
Oversees all compliance and privacy investigations.
Oversees outside investigations by government and regulatory agencies.
Develops, implements, administers, and evaluates standards, policies and procedures for the protection of system-wide health care privacy and confidentiality. Collaborates with the Security Officer to facilitate access of health care information as authorized by HIPAA, HITECH and other legal requirements, as well as organizational requirements.
Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct, and manages day-to-day operation of the Compliance Program.
Develops and periodically reviews and updates Code of Conduct to ensure continuing currency and relevance in providing guidance to management and employees.
Collaborates with other departments (e.g., Risk Management, Patient Accounting, Human Resources, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with outside counsel as needed to resolve difficult legal compliance issues.
Responds to alleged violations of statutes, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures. Develops and oversees a system for uniform handling of such violations.
Reviews and evaluates internal compliance issues/concerns to ensure that issues/concerns are being appropriately evaluated, investigated and resolved.
Monitors and, as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
Identifies and oversees auditing and monitoring activities on potential areas of compliance vulnerability and risk; and develops/implements corrective action plans, in collaboration with department managers and the Compliance Committee, for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
Provides reports on a regular basis, and as directed or requested, to keep the Compliance Committee and the Board of Trustees informed of the operation and progress of compliance efforts.
Oversees the reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
Establishes and provides direction and management of the Compliance Hotline and related reporting mechanisms.
Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline, (b) heightened awareness of Standard of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.
Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees, as well as ongoing general and specific, role-based training for all employees, volunteers, and Board members.
Monitors the performance of the Compliance Program and related activities on a continuing basis, taking appropriate steps to improve its effectiveness.
Possesses knowledge of Continuous Quality Improvement principles and supports the hospital’s philosophy of performance improvement. Participates on Quality Improvement teams as appropriate.
EDUCATION and/or EXPERIENCE:
Juris Doctorate required. A current, unrestricted Registered Nurse license, preferred, and at least five years of experience in healthcare OR equivalent combination of education and experience. Must possess a nationally recognized certification in a healthcare compliance related area (e.g., healthcare compliance, healthcare research compliance, healthcare privacy compliance, etc.) at hire or within one (1) year of hire.
Employer will assist with relocation costs.
Internal Number: 2
About Community Hospital
Community Hospital in Grand Junction, Colorado, is a full-service, acute-care hospital licensed for 60 beds. As part of the Colorado West Healthcare System, we offer full outpatient diagnostic services and inpatient care for the Western Slope region of Colorado, and eastern Utah. Community Hospital brings together expert staff and world-class technology in a healing, family-centered environment. We provide a full range of medical services, including inpatient and outpatient surgery,and emergency care. We have comprehensive diagnostic capabilities: state-of-the-art ultrasound, CT (Philips Ingenuity 128 MDCT), digital mammography and cardiac testing. Community Hospital proudly partners with University of Utah Heath Care and Huntsman Cancer Institute to provide world-class medical and radiation oncology right here at home. Community Hospital is Joint Commission accredited. Our laboratory is College of American Pathologists-accredited. For those lab tests that we don’t conduct on site, the Mayo Clinic is our exclusive partner for reference laboratory services. We pride ourselves on delivering personalized care to our patients, and in working closely with our medical-care providers in t...reating the whole person. This approach has resonated with our patients, and we are growing to meet our community’s demand. On October 15th, 2014, Community Hospital broke ground on a new four-story, 140,000 square foot, state-of-the-art facility. Our NEW hospital opened Thursday, March 17th, 2016! Where We LiveGrand Junction is located in beautiful Western Colorado and is the largest city in between Denver and Salt Lake City. An outdoor lovers paradise with hundreds of miles of mountain biking and hiking right out your front door. Fantastic winter and summer activities including skiing, snowmobiling, snowshoeing, camping, hiking and 4-wheeling on the Grand Mesa located just 45 minutes away. Enjoy the numerous lakes and rivers taht supply abundant opportunites for boating, rafting, paddleboarding, and fishing. Avoid the traffic with easy access to world class skiing in Aspen, Telluride, Vail, and Crested Butte.Come and tour one of the valley's 24 unique wineries and explore downtown Main Street with numerous unique shops and several delicious cafe's and restaurants. Journey through the awe-inspiring Colorado National Monument or catch an event at Colorado Mesa University or a Grand Junction Rockies baseball game. Your activity options are endless in Western Colorado. What do you want to do today?