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Director, Corporate Responsibility Officer (CRO)

Job ID: 4654014
Updated: January 12, 2018
Geographic Location: HomeOffice
Department: Legal
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40
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Job Summary

Under the direct supervision of the Mercy Health VP & Chief Corporate Responsibility Officer, this position contributes to the Ensemble and Mercy Health mission and vision by serving as the staff leader providing day-to-day management, integration and alignment of an effective revenue cycle-third party billing Corporate Responsibility Program (CRP) with the overarching efforts of Mercy Health Corporate Responsibility Program.   Ensemble RMC LLC is a wholly owned subsidiary of Mercy Health and provides a wide-range of revenue cycle services to Mercy Health and non-Mercy Health clients.  This position provides compliance oversight of Ensemble operational leaders and staff at local (Ohio) and remote locations (North Carolina) and provides compliance reporting required contractually by clients, Ensemble and Mercy Health governance.

  • Responsible for the overall implementation and day-to-day management of the Ensemble Corporate Responsibility Program (CRP) Plan at local (Ohio) and remote (North Carolina) locations that meets or exceeds the requirements of an effective compliance program, as defined in the Federal Sentencing Guidelines and OIG Program Guidelines for Third Party Billing Companies, under the direct supervision of the Mercy Health Vice President & Chief Corporate Responsibility Officer.
  • Coordinates and collaborates with Mercy Health, Ensemble and clients’ staff on response activities; corrective action plan development; disclosures and repayments; official documentation and reporting requested by Internal Audit, Federal, State and/or local enforcement regulatory agencies and officials.
  • Works collaboratively with the Mercy Health Vice President & Chief Corporate Responsibility Officer on program components, standards, goals, tracking resources, training, monitoring and auditing, investigations, reporting and team building efforts in an effort to align Ensemble’s revenue cycle-third party billing compliance efforts with the overall Mercy Health Corporate Responsibility Program as well as emerging internal and external compliance expectations and requirements.
  • Assists in the identification of emerging revenue cycle compliance risk areas and to oversee the implementation of revenue cycle compliance risk assessments and investigations, internal controls, monitoring and audit tools, policies and procedures and effective corrective action plans at local and remote Ensemble locations.
  • Oversees the implementation of data collection, analysis and reporting of Corporate Responsibility Program Effectiveness measures, Focus Areas, Self-Assessments, Conflict of Interest and Exclusion monitoring, and other required reporting to both Mercy Health and Ensemble governance, leadership and external Ensemble clients.

Qualifications - Minimum

  • Required Minimum Education: 4 year Bachelors Degree majoring in Healthcare Management or Administration, law or related field required, Graduate Masters Degree preferred. 
  • Five to ten years of in-depth experience in compliance within acute care, multi-facility or system healthcare operations, law, finance, revenue cycle or coding/billing either from a consulting perspective or as an employer/manager required. 
  • Coding, Auditing and HCCA compliance certification preferred. 
  • Demonstrated working knowledge of Medicare and Medicaid, including documentation, coding, reimbursement methodologies, as well as extensive familiarity with Department of Health and Human Services, Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS) rules, regulations and compliance guidance. 
  • Excellent analytic and problem-solving skills to process auditing and monitoring reports, consultant studies and data compilations to discern opportunities, identify compliance risks and prioritize recommendations. Ability to take major strategic objectives and break them down into meaningful action steps. 

Hours

Full-time, 40 hours per week, days, 8:00 a.m. to 4:00 p.m.

Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

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