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This position contributes to the organization's mission and vision by providing day-to day leadership to the system-wide compliance program designed to ensure CHRISTUS Health and Its regional organizations (herein referred to as entities) fully comply with all applicable laws and regulations. The Research and Revenue Cycle Compliance Manager is responsible for the implementation and fadlitation of ongoing compliance auditing, monitoring, reporting and education activities for revenue cycle services and the research department of CHRISTUS Hearth and its associated entities. The position will provide oversight and have primary responsibility for ensuring that there is an effective compliance program and oversight in place for the revenue cyde function and research function. Additionally, the Research and Revenue Cycle Compliance Manager will oversee activities necessary to ensure revenue cycle and research components remain in compliance with all local, state and federal healthcare program rules, regulations and administrative requirements.
This position assists the Vice President, Chief Compliance and Privacy Officer in ensuring CHRISTUS HEALTH's Compliance Program fully meets the standards for effective health care compliance programs as established by federal regulators. The position participates in the department's annual risk assessment and work plan development activities, including regulatory compliance and operational testing and monitoring and education activities that support the Compliance Program.
This position serves as a role model along with all other CHRISTUS leaders for behavior consistent with the Mission, Vision and Core Values of CHRISTUS Health.
Bachelors Degree required
Effective verbal and written communication skills, appropriately crafting messages and providing education for management and front line staff.
Knowledge of processes related to research regulatory requirements including billing and contract reviews.
Knowledge of processes related to but not limited to registration, CDM management, Local and National Coverage Decisions, Advanced Beneficiary Notices, Medicare Secondary Payor questions, third party collections and write-offs.
Basic to intermediate knowledge of ICD-10 and CPT Coding and other aspects of electronic medical record systems (Meditech, Athena and HPF preferred).
Strong planning, problem-solving and change management skills. Demonstrated leadership skills and abilities including the ability to lead diverse work teams.
Strong conflict resolution, complaint management and conflict negotiation skills.
Able to function objectively in sensitive and stressful situations,work autonomously, anticipate management and leadership concerns, and demonstrate responsiveness in the delivery of needed information.
5 years of relevant project management and compliance/auditing experience required.
Previous experience and strong knowledge of revenue cycle and research regulatory requirements and operations required.
Knowledge of and experience with Meditech preferred.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.