Catholic Health Initiatives Market Director of Integrity & Compliance -Administration - FT (Days) in DES MOINES, Iowa
Market Director of Integrity & Compliance -Administration - FT (Days)
Location: DES MOINES, IOWA, UNITED STATES
Requisition #: 2018-R0188978
Post Date: Dec 05, 2018
The Integrity & Compliance, Privacy Program is Mercy Health Network's system-wide ethics and compliance program. The Integrity & Compliance, Privacy Program is a demonstration of Mercy Medical Center-Des Moines and MHN's commitment to ensuring its operations are conducted in a manner consistent with the Mission and Core Values, in accordance with the highest standards of ethical and professional behavior, and in compliance with all laws and regulations that apply to our health care ministry. Mercy Health Network (MHN) is a joint operating agreement between Catholic Health Initiatives and Trinity Health. MHN's Integrity & Compliance, Privacy Program operates in partnership with Trinity Health, which provides compliance program resources and support to assist MHN in operating an effective program.
The Mercy Medical Center-Des Moines Integrity & Compliance, Privacy Officer serves as the leader responsible for providing leadership, direction and support in the development and implementation of the Integrity & Compliance, Privacy Program, an ethics and compliance program for Mercy Medical Center-Des Moines and its affiliated organizations. The Officer ensures the Program meets recognized standards for effective health care compliance programs as established by regulatory authorities.
Knows, understands, incorporates, and demonstrates the mission, vision, and values of Mercy Medical Center-Des Moines in leadership behaviors, practices, and decisions.
Provides leadership and direction and participates in the development and implementation of Mercy Medical Center-Des Moines Integrity & Compliance, Privacy Program ensuring the program is designed and administered to meet recognized standards for effective health care compliance programs such as CMS and DHHS–OIG. Customizes systems, resources and tools provided by Trinity Health, as appropriate, for the operations of Mercy Medical Center-Des Moines and its affiliated organizations.
Is responsible for the operation of the Mercy Medical Center-Des Moines Integrity & Compliance, Privacy Program and its affiliates.
Continually assesses the Integrity & Compliance, Privacy Program to ensure it meets standards for effective health care compliance programs as established by federal regulators. Maintains appropriate files and records to document the effectiveness of the Integrity & Compliance, Privacy Program activities.
Works in partnership with the MHN Regional Director to establish policies and procedures to address areas of significant legal, regulatory or other compliance risks impacting operations.
Ensures periodic risk assessments are performed to identify and assess potential areas of legal, regulatory and business ethics risks impacting operations.
Maintains a working knowledge of applicable Federal, State and local laws/regulations; the MHN Compliance Program, Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
Serves as the Compliance Officer and is responsible for coordination, oversight and support of Integrity & Compliance, Privacy Program activities in Mercy Medical Center-Des Moines and its affiliates.
Serves as the Privacy Officer and is responsible for coordination, oversight and support of Integrity & Compliance, Privacy Program activities in Mercy Medical Center-Des Moines and its affiliates.
Serves as the Privacy Officer and is a member of the organizations IRB (Internal Review Board).
Chairs the Mercy Medical Center-Des Moines Integrity & Compliance Committee and ensures these committees meet regularly with appropriate representation and participation of management.
Assists with coordinating and facilitating the Mercy Medical Center-Des Moines audit and legal committee.
Provides support to Local Integrity Officers (LIO) appointed by the chief executive officers of Organizations Owned by Mercy Medical Center-Des Moines. The LIOs will have primary responsibility for local implementation and operation of the Integrity Program in their organizations. Works with the Regional Director and the organization leaders in the selection and training of appointed LIOs.
Participates as a member of Mercy Health Network’s Integrity & Compliance, Privacy meetings that are designed to allow input and feedback to MHN leadership on the design and operating effectiveness of the Integrity & Compliance, Privacy Program.
Provides leadership to Mercy Medical Center-Des Moines in accordance with policies and program standards. Serves as a resource to Mercy Medical Center-Des Moines employees, medical staff and others on compliance related topics and issues.
Ensures written standards of conduct and policies and procedures are established to support the operations of the Integrity & Compliance, Privacy Program. Utilizes Trinity Health’s Standards of Conduct, tools and templates and modifies, as appropriate, to meet the operating needs of Mercy Medical Center-Des Moines.
Evaluates the ethics and compliance training needs of employees and physicians and develops plans for the delivery of effective training programs to support the Integrity & Compliance, Privacy Program using MHN or Trinity Health education and training programs, as applicable.
Oversees the distribution of the Code of Conduct and the establishment of appropriate orientation and training programs on the Code of Conduct for Mercy Medical Center-Des Moines employees, medical staff and others.
Works in partnership with management teams to ensure associates, medical staff, and board members participate in ongoing training and education programs in support of the Integrity & Compliance, Privacy Program.
Promotes continuous awareness and understanding of the Integrity & Compliance, Privacy Program, the Code of Conduct, and Mercy Medical Center-Des Moines's commitment to follow all laws and regulations through ongoing communication and awareness activities with associates, medical staff and others.
Ensures there are established procedures in place to prevent the employment, credentialing or contracting with individuals or companies that are debarred or otherwise excluded from participation in federal health care programs.
Maintains a reporting system (e.g. hotline or similar system) that provides Mercy Medical Center-Des Moines and affiliate employees, physicians and others the opportunity to report issues and concerns, including potential violations of laws and regulations, without fear of retaliation or harassment. Ensures the reporting system is effectively communicated within the facilities of Mercy Medical Center-Des Moines.
Develops and implements a plan for periodic auditing and monitoring as identified by the annual risk assessment. Works cooperatively with MHN, Trinity Health, CHI and senior leaders in developing Integrity & Compliance, Privacy Program priorities including consideration of current regulatory compliance focus areas of CMS, DOJ and DHHS-OIG.
Manages in collaboration with designated counsel, in responding to audits and investigations conducted by federal and state agencies and contractors related to Medicare, Medicaid and other federal and state health care programs and laws and regulations relating to protecting the privacy and security of patient information.
Ensures the timely investigation and follow-up on issues reported through the Integrity & Compliance Line or through other means.
Establish processes to oversee and monitor corrective actions taken in response to compliance matters identified through internal and external audits, regulatory investigations and internal monitoring activities. Facilitates coordination between MHN and Mercy Medical Center- Des Moines, when needed, to support compliance auditing and monitoring activities.
Coordinate with Human Resources in the establishment of policies and procedures in areas such as background checks, screening for eligibility to participate in federal and state health care programs, and disciplinary actions for violations of the Code of Conduct and/or policies.
Assist in response to regulatory investigations or other matters identified through the Integrity & Compliance, Privacy Program. Communicates timely with Mercy Medical Center- Des Moines leaders, legal counsel and MHN Regional Integrity & Compliance, Privacy Officer concerning significant legal and regulatory matters, including investigations conducted by the Department of Justice, Department of Health and Human Services Office of Inspector General, states attorney general and others.
Ensures Mercy Medical Center-Des Moines 's Chief Executive Officer and other senior leaders are timely informed of significant activities of the Integrity & Compliance, Privacy Program, including the status of investigations, audits or other issues requiring senior management attention and support for corrective actions.
Provide regular reports to the Mercy Medical Center-Des Moines Boards of Director (or delegated committee of the board) on the operations of the Integrity & Compliance, Privacy Program, including the status of any significant legal, regulatory or other compliance matters being addressed. Assists the MHN Regional Integrity & Compliance, Privacy Officer in preparing periodic reports to the MHN Board of Directors (or delegated committee of the board) on the operation of the program.
Supports Mercy Medical Center- Des Moines's participation in Medicare Accountable Care Organization ("ACO") programs, responsible for leadership and oversight of compliance program activities in accordance with regulatory requirements.
JOB REQUIREMENTS/ QUALIFICATIONS
- Education / Accreditation / Licensure (required & preferred):
a. Bachelor Degree in Hospital Administration, Finance, Law, Accounting, Health Information Management, Nursing, Business orother related healthcare field required.
b. Certification in Compliance and Privacy required within one year of hire.
- Experience (required and preferred):
a. Five or more years ofexperience inhealth careCompliance /Privacy is required.
b. Leadership experience in Compliance/Privacy is preferred.
c. Must have the ability to work effectively ina large, geographically diversesystem.
d. Must possess a strongworking knowledge and understanding of the health care industryregulatory environment, particularly laws and regulations pertaining toparticipation in the Medicare and Medicaid programs, fraud and abuselaws, and regulatory compliance programs.
e. Excellent written andverbal communication skills. Must be effective in presenting informationto different audiences including senior management, governance, medicalstaff and associates.
f. See attached"Essential Qualities of Integrity & Compliance, Privacy Officers"for additional position qualifications.
Requisition ID: 2018-R0188978
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Equal Opportunity Employment
Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employement without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disabilitiy or any other legally protected characteristic.