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Director, Compliance Officer

2 months ago

French Camp, California, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time
Job Summary

We are seeking a highly skilled and experienced Compliance Director to join our team at SAN JOAQUIN COUNTY HEALTH COMMISSION. The successful candidate will be responsible for leading our regulatory compliance efforts and ensuring that our organization is in compliance with all relevant laws and regulations.

Key Responsibilities
  • Regulatory Compliance: Develop and implement strategies to ensure compliance with Centers for Medicare & Medicaid Services (CMS) regulations and other external laws and regulations.
  • Compliance Program Management: Oversee the development and implementation of our Compliance Program, including program metrics, structure, and processes.
  • Training and Education: Collaborate with the Medi-Cal Program team to create and coordinate educational training programs to ensure that our workforce, commissioners, and third parties are knowledgeable about our Compliance Program, its written Code of Conduct, compliance policies, and procedures.
  • Investigations and Audits: Collaborate with the Program Integrity Unit (PIU) on investigations relative to False Claims Act (FWA) violations and other compliance issues or violations.
  • Policy Development: Collaborate with the Policy Program team in the development and implementation of policies, procedures, and practices designed to ensure compliance with the requirements set forth by the CMS contract, laws, regulations, and healthcare program requirements.
  • Leadership and Supervision: Provide leadership and supervision to direct reports, ensuring that they are equipped to perform their duties effectively and efficiently.
Requirements
  • Education: Bachelor's Degree in a related field.
  • Experience: 10 years of experience in Medicare managed care compliance, including 2 years in a management role in a health plan or managed care setting, and at least 6 years of supervisory experience.
  • Certifications: Certified in Healthcare Compliance (CHC) or comparable industry certification.
Preferred Qualifications
  • Master's Degree: Master's Degree in business, healthcare, public health, or JD.
  • Project Management Experience: Strong project management experience.
Working Conditions

The successful candidate will be required to work in an open office environment with moderate temperatures and noise levels. Eligibility for remote work may be considered.