Director of Risk and Compliance

Director of Risk and Compliance First Choice Community Healthcare

INC - 3.5

Albuquerque, NM Job Details 1 day ago Qualifications Regulatory inspections Compliance risk assessment Management Operations management Handling insurance claims Accreditation standards (regulatory compliance area) Community health center experience 5 years Regulatory compliance Compliance audits & assessments Risk mitigation strategy implementation State healthcare regulations Master's degree Policy & process development Bachelor's degree Business continuity planning Continuous quality improvement (CQI) Senior level

Leadership Full Job Description Description:

FIRST CHOICE COMMUNITY

HEALTHCARE, Inc.

POSITION DESCRIPTION TITLE

Director of Risk and Compliance FLSA Status:

Exempt Department:

Administration Reports to:

CEO Date:

10/06/2024

Date Last Reviewed:

05/28/25 A.

POSITION SUMMARY

Directly reporting to the CEO, the Director of Risk and Compliance oversees the Corporate Compliance and Risk Management Program. The Director of Risk and Compliance will examine, evaluate, and investigate eligibility for or conformity with laws and regulations governing contract compliance of licenses and permits, and perform other compliance and enforcement inspection and analysis reviews by evaluating compliance issues and concerns within the organization and implement procedures based on federal and state compliance metrics that will mitigate risks of the organization.

B. ESSENTIAL DUTIES AND RESPONSIBILITIES

• Develops initiates, maintains, and/or revises policies and procedures for the general operation of the Compliance and Risk Management Program and its related activities to prevent illegal, unethical, or improper conduct. Manages day-to-day operation of the Program.
• Periodically reviews and updates Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees;
• Collaborates with other departments (e.g., Finance, Facilities Management, Human Resources, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution.
• Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by recommending the initiation of investigative procedures. Implements and oversees a system for uniform handling of such violations, in accordance with federal and state compliance.
• Acts as an independent review and evaluation body to ensure that compliance issues/concerns within the organization are being appropriately evaluated, investigated and resolved;
• Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends;
• Conducts risk assessments, collecting and analyzing documentation, statistics, reports, and trends.
• Recommends and implements risk management solutions such as insurance, safety and security policies, business continuity plans, or recovery measures.
• Responsible for managing and processing all claims-related activities, including monitoring, tracking, and resolving claims issues.

Requirements:

C. MINIMUM EDUCATION AND EXPERIENCE

Education:

A bachelor's degree required; Master's desired.

Experience:

A minimum of 5 years' experience in a healthcare organization, to include demonstrated leadership required. Experience with operational, financial, assurance and regulations are required. Experience leading facilities through FQHC federal and accreditation surveys (Such as HRSA Operational Site Visits, and The Joint Commission) strongly preferred. Experience with FTCA (Federal Tort Claims Act) strongly preferred

D. LICENSES/CERTIFICATIONS REQUIRED N/A E. KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED

Knowledge of regulatory and contractual requirements and language; Knowledge of quality improvement philosophy models, processes and tools and their use in a health care setting and the ability to convey such to a variety of audiences; Knowledge of analytical principles and practices in a health care environment; Skill in effective application of CQI teams, quality assessment and process management initiatives; Ability to function effectively under stress and high workload, including ability to organize tasks and time effectively; Ability to communicate, both verbally and in written form, with diverse groups of people to include staff and providers, Management Team, Governing Board and government/regulatory agencies/entities; Ability to create a working environment that is conducive to group effort and organizational effectiveness; Ability to work independently with general direction Knowledge and familiarity with compliance program. Cooperate fully and comply with laws and regulations;