Director of Compliance

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Job description

Overview:
The Director of Compliance for Pediatrics will be responsible for developing, implementing, and overseeing a comprehensive compliance program tailored to the needs and regulations specific to pediatric healthcare in all pediatric settings. This role ensures that all pediatric practices, operations, and services adhere to local, state, and federal regulatory requirements and align with the organization's values and ethical standards. The Director will play a crucial role in identifying and mitigating compliance risks, fostering a culture of compliance, and promoting best practices in pediatric healthcare.

Responsibilities:
Design and implement a compliance framework that addresses the unique regulatory requirements of pediatric care, including HIPAA, OSHA, Joint Commission standards, and state-specific regulations.

Develop and maintain compliance policies and procedures that support high-quality, legally compliant pediatric healthcare.

Conduct regular assessments of compliance risk areas and update the program as necessary to address new regulations or changes in practice.

Develop and lead compliance training programs tailored to clinical, administrative, and support staff within the pediatric department.

Ensure that all team members are informed of regulatory requirements, ethical standards, and best practices in pediatric healthcare.

Oversee regular audits of pediatric operations to ensure compliance with relevant healthcare laws and regulations.

Collaborate with clinical and administrative leaders to address identified issues, track improvements, and report on outcomes to senior leadership.

Investigate compliance concerns, complaints, or potential breaches in pediatric care, maintaining confidentiality and adhering to legal standards.

Work closely with legal, quality, and patient safety teams to develop corrective action plans to mitigate risks and prevent future issues.

Keep abreast of changes in pediatric healthcare regulations and recommend necessary adjustments to policies and practices.

Liaise with external regulatory agencies as required to ensure organizational compliance and readiness for audits or inspections.

Act as a trusted advisor to pediatric clinical leaders, senior management, and staff on compliance-related matters.

Foster a culture of transparency, integrity, and commitment to regulatory excellence within the pediatric department.

Partner with cross-functional teams, including Legal, Quality, and Risk Management, to support cohesive organizational compliance efforts.

Qualifications:
Minimum Associate's Degree in a related healthcare or compliance field

At least 3 years experience in a compliance role in a pediatric or related healthcare setting. Experience in a managerial or director-level role is preferred.

Understanding of federal, state and local laws/regulations.

Excellent communication and interpersonal skills. Experience presenting to students, professional audiences, internal and external senior and executive leadership both virtually and in-person is preferred. Must be able to communicate effectively with residents, responsible parties, communities, personnel and support agencies.

Proficient use of personal computer and software applications used in job functions including but not limited to word processing, graphics, databases, spreadsheets, and electronic medical record systems. Working knowledge of navigating business intelligence and other data analytics platforms is preferred.

Must possess a thorough knowledge of Medicare, Medicaid, private pay, and any other governmental and regulatory agencies involved in skilled nursing, senior living, PACE, outpatient, pediatrics, and home health care.

Must possess a good working knowledge of reimbursement systems as it relates to industry regulation affecting the organization as well as upstream and downstream partners.

Assumes responsibility for ongoing continuing education and professional development

Able to adapt to changes in the work environment, can handle various demands and unexpected events.

Maintain confidentially of company employee information.

Attention to detail to ensure accuracy and completion.

Identifies problems and resolves them in a timely manner.

Prioritizes work activities to ensure all tasks are completed in a timely manner.

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