Compliance Program Manager

At Houston Methodist, the Compliance Program Manager position is responsible for developing and implementing comprehensive strategies and tactics that support the Houston Methodist Business Practices Program and its government-mandated compliance program elements. As the strategic lead, this position plans, directs, and/or coordinates inter-related projects to ensure that the goals and objectives of the program are met. The Compliance Program Manager position will work closely with others to coordinate and manage program resources, providing guidance, expert advice, and strategies that fit within the overall program strategy and goals. This position acts as a liaison between the Business Practices Office and Houston Methodist entities system-wide.

FLSA STATUS
Exempt

QUALIFICATIONS

EDUCATION

• Doctor of Jurisprudence (JD), Master of Healthcare Administration (MHA), Master of Business Administration (MBA) or Master of Jurisprudence (MJur); if JD, must be in good standing with State Bar Assoc.

EXPERIENCE

• Five years' experience working in health care regulatory compliance

LICENSES AND CERTIFICATIONS
Required

• Two of the following certifications required: CHC, CHRC, CHPC, CHC-F, CCEP, RHIA, CMPA, CPCO, or CPHRM within 1 year

KNOWLEDGE AND ABILITIES

• Demonstrates the skills and competencies necessary to perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Demonstrates leadership and influencing skills at all levels of the organization
• Ability to lead, coordinate, and plan for delivering/driving business goals
• Embraces strong business partnering approach
• Strong project management skills

ESSENTIAL FUNCTIONS

PEOPLE ESSENTIAL FUNCTIONS

• Manages relationships within the department and across the Houston Methodist system to ensure customer requirements are known and met, and to ensure smooth implementation of program objectives.
• Effectively communicates program information and progress to stakeholders; manages all communication channels with other departments and groups.
• Maintains high visibility of program and interactions with the appropriate executives and stakeholders and may supervise law student interns.

SERVICE ESSENTIAL FUNCTIONS

• Designs, develops, implements, and maintains a minimum of one or more elements of an effective compliance program. Provides consultative services as needed to drive the program to successful outcomes. Leads system-wide development, promotion, and maintenance of assigned components of the Business Practices Program.
• Designs, delivers and assesses educational materials for use in a variety of training modalities for all individuals at all levels of the organization, including physicians, Department Chairs, and executives. Provides detailed analysis and reporting as necessary to senior management. Develops materials & presentations for various stakeholders.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Validates program and project prioritization with senior management.
• Ensures adherence to standards and compliance with regulations. Identifies the need for and leads efforts to write policies, protocols and procedures to address system-wide business practices issues including drafting and working with others to adopt. Manages system-wide special projects that require research, data collection, analysis of processes and evaluation of applicable regulations and guidelines.
• Initiates quality improvement activities, including the use of benchmarking and sharing of best practices.
• Independently conducts complex and/or sensitive privacy and compliance incident investigations, designing and implementing System-wide corrective action plans to address areas of non-compliance to include highly complex monitoring and assessment of plan reports.
• Conducts regulatory compliance research and analysis of highly technical billing compliance risks, including fraud, waste, and abuse risk areas, and identifies the need for and leads efforts to mitigate and remediate areas of concern.

FINANCE ESSENTIAL FUNCTIONS

• Accountable for adhering to approved budget and program/project timeframes. Utilizes resources effectively and efficiently, demonstrating responsible financial stewardship.
• Ensures progress against annual goals for the program and program objectives.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Collaborates and networks to develop and seek out best practices.
• Independently seeks opportunities to identify and streamline inefficiencies.
• Builds strategies for growth, development, and promotion of the program and oneself.

SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.

• On Call* Yes

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area Yes

QUALIFICATIONS

EDUCATION

• Doctor of Jurisprudence (JD), Master of Healthcare Administration (MHA), Master of Business Administration (MBA) or Master of Jurisprudence (MJur); if JD, must be in good standing with State Bar Assoc.

EXPERIENCE

• Five years' experience working in health care regulatory compliance

LICENSES AND CERTIFICATIONS
Required

• Two of the following certifications required: CHC, CHRC, CHPC, CHC-F, CCEP, RHIA, CMPA, CPCO, or CPHRM within 1 year