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Providence Health & Services Executive Director, Compliance (Physicians) – PSJH in Renton, Washington

Description:

Providence St. Joseph Health is calling an Executive Director, Compliance (Physicians) – PSJH to join our team.

Can be based at any of our PSJH facilities.

We are seeking an Executive Director, Compliance (Physicians) – PSJH to be Responsible for oversight of compliance activities within the PSJH affiliated physician practices, laboratory services, pharmacy services and other ancillary services as may be determined.

In this position you will have the following responsibilities:

  • Provides oversight of compliance activities within physician practices and other affiliated entities. Assists the Chief Compliance Officer in developing and updating policies and procedures; identifying, developing and implementing system-wide risk assessments and program effectiveness evaluations; and developing annual work plans both for the system and regional administration

  • Provides oversight of compliance activities within physician practices and other affiliated entities. Assists the Chief Compliance Officer in developing and updating policies and procedures; identifying, developing and implementing system-wide risk assessments and program effectiveness evaluations; and developing annual work plans both for the system and regional administration

  • Provides direction, counsel and leadership supporting PSJH’s commitment to prevention of erroneous claims, contract violations and professional relationships subject to regulations and policy.

  • Works collaboratively with legal counsel on matters related to assigned responsibilities including matters under attorney client privilege

  • Oversees compliance with physicians and other clinical providers to ensure they are functioning properly and revenues and associated costs are appropriate for the services provided. Provides ongoing staff training, including educational resources such as coding newsletters and email updates.

  • Conducts regular claims reviews to find patterns of coding that may indicate risk areas.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s Degree in Business/Public Health/Health Care Administration

  • 6 years experience in a management capacity involving the oversight of employees and staff in a hospital or clinic setting.

  • 4 years success in managing a multi-hospital system compliance or related audit, education program, with a demonstrated ability to develop and conduct education programs for providers.

  • Develops the trust and confidence of PSJH physicians, case management staff, executive management and ancillary service leaders becoming the resource of choice across the system relevant to these services

  • Demonstrates high ethical standards and adheres to established professional ethical guidelines.

  • Excellent written and verbal communication skills, including the ability to present ideas and concepts effectively to PSJH executive management, physicians and employees.

  • Demonstrated ablity to analyze problems and issues from a variety of perspectives and understand the legal, reimbursement, and organizational behavioral impact of those decisions.

  • Demonstrates competence in use of various data systems (EPIC, Meditech, Allscripts, MDAudit, MS Office, etc) for data collection and analysis.

  • Maintains current knowledge of regulatory issues effecting operational units.

  • Basic understanding of billing and reimbursement systems including coding

  • CERTIFIED PROFESSIONAL COMPLIANCE OFFICER

Preferred qualifications for this position include:

  • Master’s Degree in Business/Public Health/Health Care Administration or JD.

  • Coursework/Training in Procedural and Diagnostic coding.

  • CERTIFIED IN HEALTHCARE PRIVACY AND SECURITY

  • CERTIFIED PROFESSIONAL CODER

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence St. Joseph health from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Non-Clinical Director/Executive

Location: California-Burbank

Other Location(s): California-Napa, Alaska-Anchorage, Oregon-Portland, Washington-Renton, California-Irvine

Req ID: 219888

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