BJC Careers

Director of Compliance

Saint Louis, MO
Leadership


Job Description

Job ID: 1174453
Employment Status: Full-Time
Regular/Temporary: Regular

Your Career. Made Better.

BJC Medical Group is a dynamic, multidisciplinary group with locations across the St. Louis metropolitan and outlying areas. The physicians, providers and staff of BJC Medical Group provide the highest level of care to thousands of patients every day.

The Quality and Compliance Department provides support to the strategic and operational objectives of BJC Medical Group practices is located in Town & Country, MO.


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Role Purpose

As Director-Compliance for physician services, the role will be primarily responsible for development, implementation, revision and oversight of all activities related to the billing for professional services by BJC Medical Group (BJCMG) and other BJC-affiliated organizations including, without limitation, development and management of annual compliance audit plans for physician practices and physician services, managing for cause investigations and responding to government and other external inquiries and investigations. . In addition, the position will be responsible for maintaining and expanding visibility of compliance efforts, participating in BJC’s compliance education initiatives and for recommending and implementing compliance initiatives to meet the demands of the health care regulatory environment. The position will also work closely with other members of the BJC Corporate Compliance Department to help oversee and manage BJC’s compliance with federal and state privacy laws (HIPAA Privacy Regulations, e.g.) as it relates to physician services within BJC. The incumbent will have a dyad reporting relationship to the VP-Corporate Compliance.


Responsibilities

  • Manages individual(s) including but not limited to: hires, trains, assigns work, manages & evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.
  • Develops, monitors and reports out to local and corporate leadership to ensure BJC’s physician and professional service platforms is functioning as envisioned and to implement modifications as required to ensure an effective compliance program for BJC’s physician and professional services.
  • Manages team that conducts tertiary-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal and appropriate reimbursements, legal compliance and accurate documentation while adhering to regulations prohibiting unbundling and other questionable practices.
  • Coordinates closely with BJCMG’s internal compliance team and senior leadership to assure corporate integrity is maintained. Interacts with compliance committees, government agencies/contractors, management, employees and others, as necessary, to ensure and understanding of the organization’s compliance initiatives.
  • Responsible for the review, update, coordination and formulation of policies and procedures regarding compliance related activities to ensure consistency and compliance among the various facilities and operations of BJC’s physician and professional platforms.
  • Interacts with providers regarding billing and documentation policies, procedures and regulations; obtains clarification of conflicting, ambiguous or non-specific documentation.
  • Functioning as BJCMG’s Privacy Liaison and Privacy Liaison for other BJC physician/professional service locations, directs all activities related to protecting the use, disclosure of and requests for copies of all personally identifiable protected health information (PIPHI). Collaborates with Information Security and Compliance Officers at BJC HealthCare on electronic protected health information, security and privacy compliance. Consults with Health Information Management on the administrative procedures related to PIPHI.

  • Minimum Requirements

     

    Degree

  • Bachelor's Degree
  • - Business/HC Admin/related

     

    Experience

  • 5-10 years
  •  

    Supervisor Experience

  • 5-10 years
  •  

    Licenses & Certifications

  • CHC

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Master's Degree
  • - Business/HC Admin/related
    Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer