Director Regulatory Affairs -Compliance at Nicklaus Children's Health System in Miami, Florida

Job Description:

Job Summary

Promotes healthcare compliance within the Nicklaus Health System and its subsidiaries as applicable. Responsible for the auditing, monitoring, and policy functions of the compliance department pursuant to the OIG and Federal Sentencing Guidelines for an effective compliance program. Oversee compliance education modules and related events for the entire compliance department. Tasked with conducting compliance reviews and policy development for the following: Stark Law, Place of Service, Anti-Kickback, False Claims Act, Conflict of Interest, Business Ethics, EMTALA, and any other Federal and/or State rules applicable to the health system.  Responsibility includes operation of the compliance hotline reporting and inquiry management/triage program. Responsible for initiatives and operational functions of assigned areas including governance, logistics, and collaborates with Legal, Compliance, strategic partners and stakeholders. Leads the department with a commitment to quality, service, growth, compliance, and organizational accountability.

Job Specific Duties

• Responsible in the development of the NCHS risk assessment and prepares the annual work and audit plan. 


• Develop and manage required infrastructure to respond to rapidly evolving regulatory landscape. 


• Plans audits in accordance with accepted standards.  Audits may involve travel to any or all satellite locations; assists staff members in evaluating the adequacy and effectiveness of the management controls over areas under audit. 


• Reviews, drafts, or edits audit reports as the subject-matter expert, identifies improvement opportunities, and develops value-added recommendations. 


• Supports in establishing and maintaining a compliance reporting framework that focuses on high-level NCHS risk through a process that recognizes local risk perspective and escalates critical risk intelligence to executive leadership. 


• Collaborates with designated leaders to help ensure performance of key compliance program functions including risk identification, assessment, prioritization, mitigation, and monitoring.


• Assists in implementing processes for continuous assessment and evaluation of the compliance program utilizing defined metrics. 


• Support and promote organization at regulatory meetings as assigned and represents Regulatory Affairs on cross-functional project teams by Leader. 


• Works cooperatively with stakeholders other applicable organizational medical record units in overseeing compliance effort. 


• Cultivates and maintains strategic relationships with key regulatory authorities externally.


• Receives, documents, tracks, and investigates incidents, complaints, and events concerning the organization’s privacy practices.  Works with stakeholders and workforce members to timely complete and support investigations.  Oversee process and timely completion. 


• Oversees, directs, delivers, or ensures delivery of initial and continuing compliance training to all employees in conjunction with TM&E and other relevant stakeholders.  Creates articles, tips, and training materials to educate workforce members on applicable law, policies, information security, business and medical ethics, and best practices; creates curriculum for awareness events such as compliance week. 


• Conduct on-going investigations at NCHS; work closely with general counsel, internal audit, risk management, and TM&E in furtherance of investigations of non-compliance. 


• Provide support to NCHS community including workforce, patients, and other third parties regarding regulatory mandates, customer service issues, complaints, website assistance, and support with potential incidents. 


• Cooperates with the Office of Civil Rights, Office of the Inspector General, other Governmental oversight agencies, legal entities, and organization officers in any compliance reviews or investigations. 


• Supervise and manage operation of the compliance hotline reporting and inquiry management/triage program. 


• Manage program and personnel. Develop appropriate metrics to track the success of the program, individual functions, and initiatives.  Contribute to the management and administration of the compliance program at large. 


• Provide personnel management, budgeting, and administrative support to the compliance program at large. 


• Actively establishes and cultivates an environment that puts institutional compliance at its center and builds a culture that fosters best practices and ethical conduct. 
  
   

Minimum Job Requirements

• Master's Degree Healthcare Administration, Business Administration, or equivalent discipline


• 4-7 years in leadership experience in a healthcare environment or academic medical center


• 3-5 years in progressive experience in program development, data privacy and security compliance framework, and management of vendor programs


• Experience in information privacy laws, access, release of information, and release control mechanisms


• Experience leading a team toward building confidence and striving toward established goals


• Experience developing partnerships, supporting initiatives, and programs with relevant stakeholders


• Experience with developing compliance concepts to contribute and embed into organizational culture of excellence and regulatory compliance

Knowledge, Skills, and Abilities

• CHC or achieve certification within first year of employment preferred.


• Savvy in presenting strategic regulatory recommendations and establishing trusted relationships.


• Builds connections by developing positive and collaborative partnerships that drive sustainable business results.


• Extensive knowledge of regulatory mandates, development of programs, and procedures to comply.


• Skilled in presenting to stakeholders and providing education and awareness.


• Excellent organizational skills, detail oriented, and effective written/oral communication skills.


• Ability to direct, manage, implement, and evaluate department operations.


• Professional and customer service oriented when dealing with patients, community, all levels of administration, and workforce.