Fair Haven Community Health Care 

FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 80,000 office visits in 17 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.”

For nearly 50 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay.

Job purpose

Provides professional direction, oversight and advice to the Health Center’s Compliance and Quality Improvement Programs, which incorporate all clinical and administrative departments. Serves as the designated Chief Corporate Compliance Officer for the Health Center and is responsible for implementation of the Compliance Program. (For this responsibility reports to the CEO and Board of Directors).

Duties and responsibilities

• Develops the Health Center’s Corporate Compliance Plan for the review and approval by the Board.
• Oversees and monitors the implementation of the Corporate Compliance Program.
• Reports to the CEO and the Board of Directors on a regular basis (e.g., Compliance Dashboard reports, policy development, any significant changes to regulations or accrediting standards, etc.)
• Serves as a member of the Health Center’s Executive Management Team.
• Works collaboratively throughout the organization in a leadership, advisory and facilitative capacity utilizing interdepartmental teams and training systems to achieve corporate compliance, quality improvement and risk management goals and objectives.
• Investigates potential incidents pertaining to healthcare coding, billing and reimbursement, any allegations of fraud, abuse or conflict of Interest, suspected or actual breaches of privacy, confidentiality, and security.
• Chairs the Corporate Compliance Committee and serves as a member of the Quality Improvement Council and the Accreditation Committee.
• Manages Compliance communication processes, ensuring anonymity of sources, and coordinates with other departments to ensure issues are appropriately addressed.
• Develops policies and procedures related to standards of conduct, compliance with applicable laws and regulations, and the reporting of suspected fraud or impropriety without fear of retaliation.
• Supervises the work of the Director of Practice Transformation and Accreditation, who has  responsibility for ensuring compliance with standards issued by accrediting organizations and with Section 330 requirements from the Bureau of Primary Health Care. The majority of programs at FHCHC are supported by grant funding that involves research and data collection/evaluation, often conducted by a third party.
• Reviews and approves contracts on behalf of the corporation and consults with legal counsel
• Accountable to public and private sources and funders for funds they provide to the center
• Ensures the center is in compliance with corporate, legal and licensure, including The Joint Commission (TJC) oversight, HRSA and other accrediting and funding bodies
• Responsible for the development of the Department’s budget and its strategic and operating plans.
• Develops, monitors, revises and ensures implementation of the Compliance Program in response to changes in the law; consults with department/program representatives, as necessary to ensure program effectiveness.
• Develops, performs, supervises and arranges appropriate training and education of all staff, clinicians, and Board members on compliance requirements.
• Analyzes the findings from any internal or external audits and programmatic site visits to assess compliance with applicable laws, regulations, and standards.
• Establishes and manages a reporting system for employees to report concerns and obtain assistance; ensures adequate mechanisms exist for enforcement of compliance requirements and violation discipline.
• Ensures adequate records are maintained to document compliance efforts and corrective actions.
• Conducts, supervises, or coordinates internal investigations of alleged compliance violations.
• Coordinates with external officials and FHCHC administration ensuring remediation of any confirmed non-compliance.
• Communicates, or participates in the development of communications with regulatory agencies regarding investigations and the resolution of any alleged violations.
• Conducts, or participates with departmental managers in conducting risk assessments to specifically identify whether any corrective actions are needed.
• Ensures that the Health Center conducts regular verifications to safeguard that the Health Center’s clinicians have not been excluded from participation in Federal health programs.
• Collaborates with the Director of Practice Transformation and Accreditation in the analysis of any new or proposed revisions to policies and procedures that have been developed by FHCHC. departmental management, to ensure compliance with existing regulations and accrediting standards.
• Represents FHCHC in compliance-related standing or ad hoc work groups convened by CHCACT.
• Supervises the work of the Director of Risk Management and Safety, who is responsible for coordinating and implementing FHCHC’s risk management and patient safety program on a daily basis.
• Supervises the work of the Compliance and Privacy Associate, who collaborates in inter-departmental audits based on FHCHC’s Corporate Compliance Work Plan and in Privacy Rounds conducted by the HIPAA Privacy Officer.
• Responsible for the management and processing of claims-related activities for FTCA.
• On a daily basis, serves as FHCHC’s point of contact for FTCA claims management.

Qualifications

Knowledge

• Comprehensive subject matter expertise in health care compliance and quality improvement
• Exemplified expertise in engaging the commitment of staff, clinicians, administrators, and board    members in a shared “Culture of Compliance” at the Health Center
• Superb planning, analytic, and problem-solving skills
• Demonstrated senior leadership and intra-departmental management skills
• Excellent communication (verbal, written, and presentation) skills to convey information to diverse audiences
• Experience in training and developing education programs
• Minimum 3+ years in a health care compliance or regulatory role, preferably within a federally      qualified health center or an ambulatory health care environment
• Effective team leadership and team participation skills board and the public; possesses a consistent and disciplined demeanor and ability to act as a professional role model internally and externally
• Tact and discretion in the conduct of investigations
• Demonstrated knowledge of ambulatory coding and reimbursement
• Additional experience in healthcare operations
• Demonstrated knowledge of federal and state laws & regulations and accreditation requirements
• Skilled in quality improvement, systems change, and policy development

Technical Qualifications

• Bachelor’s Degree required, Master’s in healthcare administration preferred.  Candidates with a JD and significant compliance experience are welcome to apply.
• Certification in Health Care Compliance (CHC) preferred.
• Proficiency in the use of WORD products (Excel, PowerPoint, Publisher) and EHR systems, preferably Epic

Direction of Others

Director of Practice Transformation and Accreditation

Director of Risk Management

Compliance and Privacy Associate

 

 

OSHA Status

Category III—Low Risk Position

Generally works in an office environment with no exposure to bloodborne pathogens

Physical requirements

Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records,

Mental Demands: Ability to cope with continual changing priorities under potentially stressful conditions

Manual Dexterity Required:  Ability to use a keyboard, telephone.

American with Disabilities Requirements

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.