Director, Compliance

🕒 6 days ago

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2022-03

Consulting • Insurance • Logistics

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Provide Compliance Program leadership for assigned service lines and/or locations • Oversee compliance investigations and ensure reported concerns and suspected violations are evaluated, investigated, and resolved • Lead the Investigations team and personally manage compliance investigations • Oversee intake, triage, prioritization, and assignment of reported compliance matters • Coordinate corrective action plans, overpayment/refund activities, claim corrections, and systemic issue resolution • Develop and perform training related to investigations, government and payer coding audits, and settlements • Respond to day-to-day compliance questions and provide regulatory risk mitigation guidance • Monitor fraud, waste, and abuse laws, regulations, and industry changes affecting healthcare revenue cycle services • Prepare reports on investigation activities, findings, and outcomes • Serve as Compliance Liaison to assigned Ensemble clients and/or service lines • Act as primary compliance point of contact for assigned clients and/or service lines • Facilitate communication of compliance matters, regulatory updates, and Compliance Program expectations • Attend and support recurring client and service line compliance meetings • Identify, triage, and escalate compliance concerns and support resolution and follow-up • Support client-facing audit, monitoring, and reporting activities • Coordinate distribution of compliance communications to assigned stakeholders • Maintain documentation of liaison activity

🎯 Requirements

• Leadership decision-making, delegation, team leadership, and executive communication skills • Program and project management expertise • Ability to evaluate, manage, investigate, and resolve compliance concerns and suspected misconduct • Knowledge of Compliance Program requirements and regulatory risk mitigation • Knowledge of fraud, waste, and abuse laws and regulations • Knowledge of healthcare revenue cycle services • Ability to oversee government and payer coding audits, settlements, corrective actions, overpayments, refunds, and claim corrections • Ability to build trusted relationships with client compliance officers and operational leaders • Ability to facilitate compliance communication and support client-facing audits, monitoring, and reporting • Continuing education and peer-to-peer networking to maintain regulatory and industry awareness

🏖️ Benefits

• Comprehensive benefits package including healthcare, time off, retirement, and well-being programs • Professional certification relevant to the associate’s field • Tuition reimbursement • Quarterly and annual incentive programs for all employees • Remote work arrangement • Work-life flexibility • Professional development and growth opportunities