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Director, Healthcare Compliance



Title: Director, Healthcare Compliance

Department Org: UTMC Compliance - 109020

Employee Classification: U1 - Unclassified PSA FT

Bargaining Unit: Professional Staff Association

Primary Location: Main Campus - Administration

Shift: 1

Start Time: 8:30am End Time: 5pm

Posted Salary: $103,530 - $129,386

Float: False

Rotate: False

On Call: True

Travel: False

Weekend/Holiday: True

Job Description:

The Director of Healthcare Compliance is responsible for assisting with overseeing and guiding the Healthcare Compliance Program. Duties would include ensuring ethical and compliant practices are implemented and maintained across the organization in accordance with all applicable federal and state laws, regulations, ordinances, commercial payers' rules and regulations internal policies and procedures, and other requirements as they relate to operations, billing, coding, proper payment, documentation practices, and the delivery of quality care in a compliant manner. This person will oversee doing investigations in the field, working with the Chief Assurance Officer and strategic input from general counsel, responding to and investigating anonymous reporting hotline calls, and managing risk as it relates to compliance issues.

Locations Served: University of Toledo, University of Toledo Medical Center, University of Toledo Physicians, College of Medicine and Life Sciences, Health Science Campus, ACE

Minimum Qualifications:

Education/experience/licensing:
• Must have a minimum of seven (7) to ten (10) years of experience in healthcare operations.
• Bachelor’s degree required with emphasis on nursing, healthcare administration, healthcare information technology, compliance, or clinical-based competency
• Working knowledge of medical terminology, CPT, and ICD-10
• A minimum of three (3) to five (5) years of experience as a certified physician coder preferred RHIT, RHIA, or Certified Degree in Coding (preferred)
• Minimum of two (2) years of supervisory experience of professional staff
• Prior experience in leading a complex healthcare compliance function that includes an academic medical center, physicians practice plan, and college of medicine

Professional Standards:
• Work independently. Must be of ethical character. Must maintain strict confidentiality protocols.
• Must be objective and independent when conducting reviews.
• Adheres to the workflow design established for department and meets all job performance standards.
• Maintain a professional and constructive manner with all UT/UTMC/UTP employees.

Communication and other skills:
• Must have demonstrated leadership skills, strong written and verbal communication skills, and ability to work independently.
• Must have ability to escalate confidential and sensitive matters involving privacy and compliance.
• Current knowledge of healthcare, federal and state privacy regulations, and third-party regulations regarding medical record documentation
• Must have ability to monitor advancements in information technology to ensure organizations adoption and compliance.
• Strong positive verbal and written communication skills.

Conditions of Employment:

To promote the highest levels of health and well-being, the University of Toledo campuses are tobacco-free. To further this effort, the University of Toledo Health Science Campus Medical Center is requiring candidates for employment to be nicotine-free. Pre-employment health screening requirements will include cotinine (nicotine) testing, as well as drug and other required health screenings for the position. With the exception of positions within University of Toledo Main Campus and the University of Toledo College of Medicine and Life Sciences, the employment offer is conditional upon successful completion of a cotinine test and Occupational Health clearance.

Equal Employment Opportunity Statement:

The University of Toledo is an equal opportunity, affirmative action employer. The University of Toledo does not discriminate in employment, educational programs, or activities on the basis of race, color, religion, sex, age, ancestry, national origin, sexual orientation, gender identity and expression, military or veteran status, disability, familial status, or political affiliation.

The University is dedicated to the goal of building a culturally diverse and pluralistic faculty and staff committed to teaching and working in a multicultural environment and strongly encourages applications from women, minorities, individuals with disabilities, dual-career professionals and covered veterans.

The University of Toledo provides reasonable accommodation to individuals with disabilities. If you require accommodation to complete this application, or for testing or interviewing, please contact the Human Resources Department at 419-530-4747 between the hours of 8:30AM and 5:00PM or apply online for an accommodation request.

Computer access is available at most public libraries and at the Office of Human Resources located in the Center for Administrative Support on the Main Campus of the University of Toledo.

Advertised: 11 Apr 2024 Eastern Daylight Time
Applications close:

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