Title: Executive Director & Clinical Compliance Officer

Location: Midtown

Org Unit: Compliance and Privacy Office

Work Days: Monday-Friday

Exemption Status: Exempt

Salary Range: $225,400.00 - $262,500.00

*As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices

Position Summary

Oversees the effectiveness, operation, administration, and management of the Clinical Compliance and Privacy programs. Provides strategic direction and oversight for all clinical compliance and privacy program matters. This includes oversight of the professional fee billing compliance, research billing compliance, Release of Information (ROI) management, adherence to the Accountable Care Organization compliance program, and privacy. Serves as the senior-level liaison representing the organization’s clinical compliance and privacy programs to all WCM departments and across the tripartite system.

Job Responsibilities

• Provides strategic direction and oversight regarding all clinical compliance program matters.

• Manages the preparation and presentation of executive summaries of audit and review results along with corrective action plans, and reports these to the Chief Compliance and Privacy Officer and Clinical Compliance Oversight Committee.

• Offers executive level assistance, advice, and guidance on complex clinical compliance and privacy matters.

• Leads investigations or project steps within broader projects, ensuring consistent application of ethical business principles, organizational policies and procedures, and regulations.

• Stay abreast of technical coding guidelines and governmental and payer regulations, as well as evolving privacy laws, and ensure dissemination of current information to the compliance and privacy teams.

• Ensure that the clinical compliance and privacy program remains comprehensive and, meets regulatory compliance requirements, as well as applicable Federal, State, and Local regulatory agency guidelines and laws, including the HIPAA regulations.

• Oversees the management and supervision of staff development, performance, and team building, leveraging knowledge and skill sets of all reporting positions to identify and manage compliance and privacy program risk effectively.

• Oversees the development and presentation of clinical compliance and privacy education programs.

• Oversees Research Billing Compliance activities, ensuring compliance with regulatory requirements and effective management of risk assessment and audit plan, reports, and education materials.

• Oversees the Release of Information (ROI) Management processes, including compliance with regulatory requirements relating to timely and accurate release of records, amendments, restrictions, and accounting of disclosures.

Education

• Master's Degree in Business administration, Juris Doctor, Health Administration, or related field required.

Experience

• 10 -15 years of progressively responsible management experience in healthcare compliance related to risk identification and remediation, audit programs for medical record documentation, coding, and revenue cycle integrity, and relevant laws and regulations, including fraud, waste and abuse laws, Medicare Conditions of Participation, the Stark and Anti-kickback statutes, HIPAA, FDA, DPH, and HHS-OCR).

• Experienced in providing strategic leadership, communication, collaboration, and investigation to ensure adherence to regulatory requirements. Skilled in managing risk, implementing corrective action plans, and maintaining regulatory alignment.

Knowledge, Skills and Abilities

• Strong leadership, communication, and collaboration skills.

• Requires knowledge of industry issues, managing complex projects, and Federal, State and Local regulatory agency guidelines and laws.

Licenses and Certifications

• Requires professional certification in a compliance related field of expertise, such as internal audit, fraud investigation, health care compliance, or healthcare information management, multispecialty professional fee coding and billing.

• Certification examples: RHIA Certified Professional Coder (CPC, CCS-P), Certified Hospital Coder (CCS- H) Certified Medical Compliance Officer (CMPO), Certified Professional Medical Auditor (CPMA), HCCA Compliance (CHC), etc.

Working Conditions/Physical Demands

Weill Cornell Medicine is a comprehensive academic medical center that is committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists in New York City and around the world. Our doctors and scientists - faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization - are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Lower Manhattan Hospital, NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital, NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, and NewYork-Presbyterian/Queens. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients - the center of everything we do. Weill Cornell Medicine is an Equal Employment Opportunity Employer. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.