DaVita Director (HCP) in DENVER, Colorado

Director (HCP)

Description

Overview:

To perform compliance oversight,prevent and detect fraud, waste and abuse and mitigate compliance risk for theMarket medical group, coordinated care, and related businesses, and managecompliance projects, programs, and processes and report progress to complianceand Market leadership.

EssentialFunctions:

  • Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

  • Supports the National Compliance Program and provides “boots on the ground” in the Market to ensure an effective compliance program operates consistently within the Market. This includes providing compliance training to new hires, following up on on line compliance training, informing Market leaders on compliance policies and conducting compliance committee updates.

  • Manages compliance projects, programs, and processes and report progress to Compliance Department and senior leadership.

  • Identifies new risks and projects through various intakes, including regular meetings with stakeholder leadership, legal, and external sources; and collaborates with the operators to implement compliance solutions.

  • Improves processes, implement controls, and develop and implement the HCP National Compliance Program within the market.

  • Oversees arrangements to include provider compensation, acquisition transactions and other provider related arrangements in order to document compliance with Anti-kickback statute and Stark Law.

  • Understands and documents key processes, programs and initiatives.

  • Works with internal/external attorneys to assess identified risk.

  • Manages Compliance Department initiated investigations, including interview/fact finding and analysis, presentation of recommendations to executive leadership, and remediation/root cause process enhancements.

  • Manages special projects, including root/cause analyses, data analytics, process improvement, and control development.

  • Partners with other directors in compliance & leadership to manage larger compliance team.

  • Represents Compliance Department at various business leadership meetings.

  • Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

  • Performs additional duties as assigned.

Qualifications

Education:

Minimum: Bachelor’s degree from afour-year college required.

Preferred: Master’sdegree in Healthcare Administration, Business Administration, or related fieldpreferred.

Experience:

  • Minimum seven (7) years’ experience in healthcare required.

  • Minimum five (5) years management experience required.

Preferred:

  • Prior experience with health plans or managed care organizations, or large, decentralized health care providers preferred.

Knowledge,Skills, and Abilities:

  • Demonstrated knowledge of federal fraud and abuse laws required.

  • Demonstrated ability to present and communicate effectively with executive management.

  • Experience supervising work performed by outside vendors and contractors.

  • Superior drafting and communication skills required.

  • Proven track record of collaborative problem solving with senior management and business leaders to achieve business goals.

  • Excellent computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook.

  • Demonstrated experience with managing data analytics projects.

  • Travel required: up to 25% of time.

Primary Location CO-DENVER - 80202

Req ID: 319948