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UCSD Health System
 

Payroll Title:

DIR

Department:

SHARED CORP OFFICE-COMPLIANCE

Salary Range

Commensurate with Experience

Worksite:

Other

Appointment Type:

Career

Appointment Percent:

100%

Union:

Uncovered

Total Openings:

1

Work Schedule:

Days, 8 hrs/day, Mon-Fri

#70833 Director, Corporate Compliance

Filing Deadline: Fri 5/29/2015

DESCRIPTION

In just over four decades, UC San Diego Health Sciences has gained international recognition as a place where discoveries are delivered — bringing breakthroughs from the research lab bench to our patients’ bedsides. UC San Diego Health Sciences is composed of clinical and academic entities — UC San Diego Health System, UC San Diego School of Medicine, and Skaggs School of Pharmacy and Pharmaceutical Sciences.

The Health Sciences Compliance Department is expanding our Compliance team and seeking a Director, Corporate Compliance. This position reports into the Chief Compliance / Privacy Officer (CCPO) of the UC San Diego Health Sciences. The Corporate Compliance Director will be responsible to the CCPO for assuring that the key elements of an effective compliance program and an effective privacy program are in place and operationalized as it relates to the Corporate Compliance Unit, e.g., policies, education, risk assessments, profiling, work plan, monitoring, reporting and corrective / remedial actions and daily operations. The Director serves as a resource for focused compliance programs, such as the Medical Center’s Clinical Laboratory Compliance Program and the Health Science Research Compliance Program. In consultation with the CCPO, the Director identifies compliance issues, interprets or seeks interpretation of relevant laws, statutes and policies governing compliance issues, and co-ordinates and/or leads projects or policy redesigns to accomplish compliance with the laws applicable to UCSD Health Sciences (UCSDHS) enterprise. The goals of the Compliance / Privacy Program are to further the UCSDHS mission of providing quality health care to our patients, while at the same time, advancing the prevention of fraud, waste and abuse in our health care delivery system.

REQUIRED QUALIFICATIONS

  • Bachelor's degree (advanced degree or medical background preferred) and a minimum of 7 years’ experience in a health care compliance program, preferably in an academic medical center / practice plan management setting, with at least two years at the Director’s level.
  • A minimum of 4 years in-depth leadership experience with interpretation and implementation of federal and state privacy laws, including HIPAA and other state medical privacy laws.
  • Demonstrated ability to: (1) successfully manage a staff of at least five to ten members;(2) develop strategic hiring, development, and succession plans; (3) assess and develop core competencies among staff members; (4) ensure that staff meets or exceeds the CCPO’s key performance objectives; (5) assess compliance with Human Resource policies and implement corrective action or discipline when appropriate.
  • Experience interpreting, writing and implementing policies and with conducting surveillance audits.
  • Certified professional coder (e.g., CCS-P, CCS, CPC, CPC-H) and/or coding experience with physician billing, hospital billing and medical terminology.
  • Certified in Healthcare Compliance or must be obtained within 12 months of appointment.
  • Excellent supervisory, interpersonal, writing, editing, and effective public speaking skills.
  • Strong analytical and detail oriented skills.
  • Strong quantitative and computer skills.
  • Ability to provide leadership and work in a collaborative environment.
  • Knowledge of federal and state health services regulations, including Medicare, Medi-Cal, and other third-party payers billing guidelines (professional fee billing and hospital billing).
  • Working knowledge of medical coding and billing procedures, teaching physician regulations, professional fee billing and hospital facility billing, including CPT coding, ICD9 & 10, modifiers, DRGs, APCs.
  • Experience implementing and enforcing policies, procedures and standards of conduct.
  • Experience conducting internal monitoring and auditing; and responding promptly to detected offenses, developing corrective actions, and reporting findings to Government agencies via established channels.
  • Knowledge of federal and state privacy and security laws; experience with designing and conducting surveillance monitoring to detect unauthorized activity.
  • Demonstrated ability to: (1) interpret privacy regulations (federal and state laws); (2) apply preemption analyses to privacy questions and situations; (3) seek clarification from subject matter experts, such as the CCPO, HR Director, Risk Manager, Information Security Officer, CIO, and UC general counsel for privacy questions, as needed; (4) explain the rationale for conclusions; (5) implement and enforce policies, procedures; and (6) document the mitigation and resolution of privacy incidents and complaint investigations.
  • Experience and demonstrated ability to consistently interact and negotiate with all members of the organization in ways that enhance understanding, respect, cooperation and problem-solving.
  • Demonstrated knowledge, skills, or ability to work independently, manage multiple activities simultaneously, solve problems, set priorities for self and others. Develop operating procedures and processes. Ability to work calmly and effectively when under pressure, and to effectively manage time in a changing environment.
  • Demonstrated ability to: (1) Identify key issues critical to the success of a desired product / outcome; (2) Quickly research and analyze data; (3) Integrate essential information; (4) Utilize the analysis to define and test options and alternatives; and (5) Develop recommendations and justification for the most productive course of action. This requires insightful and creative skill in reasoning and logic, as well as quantitative analysis.

    SPECIAL CONDITIONS

Work location: 1450 Frazee Rd., Mission Valley



University of California, San Diego (UCSD) Health System is the only university-based medical facility in San Diego, providing leading-edge care in patient care, biomedical research, education, and community service. We have two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Center, the Sulpizio Family Cardiovascular Center, and several outpatient clinics. UCSD Medical Center, Hillcrest is also a designated Level I Trauma Center and has the only Burn Center in the county. U.S. News and World Report’s 2010-2011 annual "America’s Best Hospitals" report ranks UC San Diego Health System among the best in the nation in five specialty areas: Diabetes & Endocrinology, Geriatrics, Orthopedics, Psychiatry, and Pulmonary. We invite you to join our dynamic team!

 

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

 

UC San Diego Health System is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html


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