- Senior
- Office in Phoenix
Summary:
The Director of Compliance is responsible for developing, implementing, and overseeing MBI’s compliance program to ensure adherence to all applicable federal, state, and local laws, regulations, and industry standards. This role requires a deep understanding of the healthcare industry, including credentialing, coding, billing, healthcare and privacy regulations. The Director of Compliance will collaborate with leadership to foster a culture of compliance and ethical conduct. This position is responsible for working closely with the executive management team to ensure consistent readiness of all regulatory requirements.
Work Schedule: Monday through Friday, 8:00 AM – 5:00 PM
Work Location: (Onsite) 77 E. Thomas Rd., Phoenix, AZ 85012
Must be flexible to travel to Arizona clinics for state medical audits.
Compliance Management Duties:
- Proactively reports to and educates the Executive team and the management team regarding regulatory compliance and related issues, new statutes/guidelines.
- Consults with management, medical staff and department directors on compliance issues.
- Develops risk-based compliance testing of existing procedures and controls to identify, detect and correct noncompliance.
- Reviews and analyzes reports in relation to compliance.
- Facilitates work process teams as requested/needed.
- Develop, implement, and maintain a comprehensive compliance program aligned with organizational goals and industry best practices.
- Stay abreast of healthcare laws, regulations, and industry standards to ensure compliance.
- Conduct regular risk assessments to identify potential compliance vulnerabilities.
- Develop and implement policies and procedures to mitigate compliance risks.
- Oversee compliance training and education programs for all employees.
- Conduct internal audits and investigations to assess compliance with laws and regulations.
- Respond to regulatory inquiries and audits in a timely and effective manner.
- Monitor industry trends and emerging compliance challenges.
- Assists staff with developing a systematic approach to data collection, measurement, assessment, and improvement of processes.
- Participates in departmental and association wide informational meetings and in services, including staff meetings, association wide forums, and seminars.
- Reviews department and association wide policies and procedures annually. Develops and maintains new policies and procedures as needed.
- Perform other duties as assigned
Minimum Qualifications:
- EDUCATION: Bachelor’s degree in a medical, business, or related field, or an equivalent combination of relevant education and experience. Master’s Degree Preferred.
- EXPERIENCE: At least five (5) years of experience as a medical staff manager or director or a similar position in the medical field preferred and at least one (1) year experience in payer credentialing
- LICENSURE OR CERTIFICATION: CRCM, CCEP or CPMSM certified, highly preferred. RN is a plus.
- Healthcare industry experience, preferably in a compliance or credentialing role
Knowledge, Skills and Abilities:
- Deep understanding of healthcare regulations, including HIPAA, Stark Law, and Medicare/Medicaid guidelines.
- Strong leadership and project management skills.
- Excellent analytical and problem-solving abilities.
- Effective communication and interpersonal skills.
- Ability to prioritize and manage timelines.
- Ability to complete routine reports and correspondence.
- Ability to listen and accurately interpret others’ communication or instructions to take appropriate action.
- Ability to speak effectively before groups of customers or employees of organization.
Benefits:
At MBI, our commitment to providing accessible and convenient care to individuals injured at work is a team effort. Every employee and role are essential and valued. Rewarding the dedication and commitment of our employees extends beyond a paycheck. In addition to competitive salaries, we offer to full-time employees:
- Group Medical, Dental, and Vision Insurance
- Life, Short-Term, and Long-Term Disability Insurance
- 401(K) with company match
- Generous Paid Time Off and Company Paid Holidays
- Colleague Referral Bonus Program
Equal Opportunity Employer