Chief Privacy & Clinical Compliance Officer
New York City, NY, USA | Weill Cornell Medicine
Industry:Healthcare - Hospitals
Functions:Legal / Compliance
Job Description:60 people have viewed this job
Responsible for leading, planning, supervising, reporting results, monitoring, and evaluating the WCM compliance programs for professional fee billing (in accordance with CMS regulations) as well as Privacy (in accordance with the HIPAA regulations). Makes reports and recommendations on billing or privacy compliance matters to senior leadership. Leads both the Billing Compliance and the Privacy Compliance Oversight Committees.
Develop and implement communications and training programs for billing and privacy compliance to meet mandated requirements. Track participation and publicize system(s) for employees to report violations of billing compliance standards or breaches of PHI.
Develop and implement policies, systems, and procedures for problems with professional fee billing and privacy of protected health information. Direct compliance audits and investigations; establishes risk assessments. Provides reports and recommendations.
Establishes and administers a systematic process for receiving, documenting, tracking, investigating and taking action on all complaints/issues concerning the WCMC privacy and/or billing compliance plans.
Establishes methods to track access to ePHI and provide report on activity. Works with technical teams on alerts and analysis of retrospective data. Works with POIS on patient rights to inspect, amend, and restrict access to protected health information.
Maintain awareness of laws and regulations and assess internal risks and business impacts. Participate in industry groups focused on billing or privacy compliance. Identify opportunities to further corporate compliance responsibility programs.
Maintain system of management reporting to provide faculty practice and WCMC executive staff with timely and relevant information on compliance issues. Collaborate with PO departments on compliance program requiring their technical expertise.
Oversees the management of external audits and investigations related to billing and/or privacy rules and provides updates to appropriate executive committees. Provide recommendations and guidance to the organization
Provide oversight and coordinate efforts with departments to conduct investigations, report findings related to specific violations or substandard systems or processes, and formulate and implement corrective action toward resolution of violations.
Doctorate of Jurisprudence (JD) in related field
Experience in conducting or managing audits and/or investigations. Ten years of experience leading a billing compliance or privacy function, preferably at a large and complex heath care institution
Knowledge, Skills and Abilities
Demonstrated strong leadership and communication skills.
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