Vice President, Audit and Compliance (15845)
Company: CareOregon Inc
Posted on: February 25, 2021
Career Opportunities: Vice President, Audit and Compliance
(15845) Position Title: Vice President, Audit and Compliance
Department: Audit and Compliance Title of Manager: Chief Executive
- Provides strategic leadership for audit and compliance
activities across the organization in support of the Medicaid,
Medicare, and other populations and in compliance with the Centers
for Medicare & Medicaid Services (CMS) and the Oregon Health
- Ensures the internal audit function applies a systematic and
disciplined approach to evaluating the effectiveness of operational
quality control, compliance, and governance processes.
- Oversees the regulatory audit function and serves as an
effective bridge between the business and regulatory agencies,
managing communications and assisting the business in meeting the
requirements of state and federal regulators.
- Ensures compliance operations function effectively, oversees
contractually required reports and ensures documentation in a
centralized location, and routinely monitors compliance with
contractual service level agreements.
- Develops and continually monitors and evaluates the Compliance
and Risk Management Programs, working collaboratively across the
organization to identify and remediate areas of risk.
- Oversees the delegation oversight function in ensuring large
subcontractors meet the requirements to receive delegated
- Ensures the regulatory compliance function effectively manages
compliance processes from intake, interpretation, solution
implementation, to compliance operations handoff. Ensure proper
reporting of violations or potential violations as appropriate and
- Develops, implements, and oversees healthcare compliance and
privacy training and communications strategies, plans, content, and
associated materials; develop metrics to determine effectiveness of
- Identifies compliance and risk management performance metrics;
ensures the timely and accurate monitoring and reporting of
performance against metrics.
- Ensures HIPAA and 42 CFR Part 2 privacy and security related
laws, rules and guidelines are effectively adhered to.
- Ensures effective monitoring, reporting, and investigating of
suspected Fraud, Waste and Abuse (FWA), and the implementation of
timely corrective actions.
- Reports status of compliance program effectiveness to the CEO,
key executives, and the Board committees responsible for Compliance
oversight; coordinates with federal and state regulators.
- Acts as a resource, internal consultant, and educator for
compliance, privacy, regulatory and risk management issues; may
serve as a sponsor for key projects and initiatives. Strategic
- Leads the development of vision and goals for the audit and
- Develops and refines strategic plans, including risk
assessments, compliance plans, and risk management plans, in
alignment with organizational vision and goals.
- Defines operational structure for areas of oversight and
- Participates in the strategic planning process for the
- Maintains an enterprise view while establishing business unit
- Develops budgets in alignment with strategic planning.
- Ensures teams have sufficient resources to perform their
- Ensures budgets are monitored and managed effectively across
areas of oversight.
- Approves resource allocations within budget, including people,
finances, and timelines; makes decisions on exceptions.
- Ensures strategic messages are regularly and effectively
relayed to management team and staff; promotes transparency.
- Leverages current relationships and forges and leverages new
relationships with community partners, vendors, and other
constituents in alignment with organizational direction and
- Collaborates with leaders across the organization in
identifying integrated improvement strategies and ensuring
- Represents the organization in external meetings and functions,
providing strong leadership presence and effectiveness. People
- Directs teams and establishes team and management direction and
- P rovides team members with ongoing understanding of the
strategic direction of the organization.
- Performs employment functions in collaboration with Human
Resources, including staffing, recruitment, performance management,
professional development, and termination.
- Coaches, inspires, and recognizes staff.
- Creates opportunities for professional development.
- Fosters a culture of success in alignment with the
organizational mission, vision, and values. Essential
- Supports and operates in alignment with the organization's core
- Strives to meet work goals that contribute to departmental and
- Adheres to organizational standards, policies and procedures,
as well as compliance requirements.
- Performs other duties as assigned. Technical Knowledge, Skills
and Abilities Required
- Strong understanding of managed healthcare operations
- Understanding of State and Federal compliance plan requirements
for Medicaid (and preferably Medicare)
- Knowledge of HIPAA Privacy and Security laws, practices,
access, release information and release control technologies
- Knowledge of the Patient Protection and Affordable Care
- Knowledge of OAR's and their purpose
- Thorough knowledge of accounting practices/procedures and
- Understanding of, and adherence to, the Auditors Code of Ethics
and the Standards for the Professional Practice of Internal
Auditing as developed by the Institute of Internal Auditors
- Basic understanding of information systems
- Understanding of contract law and maintenance of policies and
procedures related to contracts entered into by corporate
- Ability to perform or oversee the performance of risk
assessments and/or gap analysis
- Strategic leadership skills, including the ability to
effectively guide the organization in the areas of audit,
compliance, and risk management
- Ability to build, oversee, and motivate teams
- Excellent written and verbal communication skills, including
- Ability to think logically and creatively without undue
influence from personal biases
- Ability to build conceptual models, communicate complex ideas
effectively, and drive change
- Ability to serve in an internal consulting role to
organizational leadership Physical Skills and Abilities Required
Lifting/Carrying up to 0 Pounds Pushing/Pulling up to 0 Pounds
Pinching/Retrieving Small Objects Crouching/Crawling Reaching Above
Shoulders Shoulder/Neck Movement 0 hours/day 0 hours/day 0
hours/day 0 hours/day 0 hours/day 0 hours/day 3-6 hours/day
Standing Walking Reading Hearing Speaking Clearly 0 hours/day 0
hours/day 0 hours/day 0 hours/day More than 6 hours/day More than 6
hours/day More than 6 hours/day 3-6 hours/day Cognitive and Other
Skills and Abilities Required Ability to focus on and comprehend
information, learn new skills and abilities, assess a situation and
seek or determine appropriate resolution, accept managerial
direction and feedback, and tolerate and manage stress.
- Minimum 5 years' experience managing people Preferred:
- Management experience in Medicaid and Medicare compliance
- College degree in Business, Health Care Administration, Law, or
related field Working Conditions
- Environment: This position's primary responsibilities typically
take place in the following environment(s) (check all that apply on
a regular basis):
- Travel: This position may include occasional required or
optional travel outside of the workplace, in which the employee's
personal vehicle, local transit, or other means of transportation
may be used.
- Equipment: General office equipment Candidates of color are
strongly encouraged to apply. CareOregon is committed to building a
linguistically and culturally diverse and inclusive work
environment Veterans are strongly encouraged to apply.-- Equal
opportunity employer. This company considers all candidates
regardless of race, color, religion, sex, sexual orientation,
gender identity, national origin, disability or veteran status.
Keywords: CareOregon Inc, Saint Joseph , Vice President, Audit and Compliance (15845), Executive , Oregon, Missouri
Didn't find what you're looking for? Search again!