Under minimal supervision, the Director of Compliance and Internal Audit works with the Chief Compliance and Audit Officer in the day-to-day operational management of ethics, compliance and internal audit for the Denver Health enterprise. This includes oversight of compliance and internal audit activities for the Denver Health Medical Plan (DHMP) and Denver Health and Hospital Authority (DHHA). The Director of Compliance and Internal Audit is responsible for coordination and implementation of the enterprise-wide annual risk assessment and work plan and plays an integral role in the development and maintenance of corporate and program specific metrics, scorecards and dashboards. Additionally, the Director of Compliance and Internal Audit will report findings and recommendations to the Chief Compliance and Audit Officer on the areas where compliance gaps are found based on risk assessment outcomes and industry and government focus areas and will recommend plans of correction and track program progress toward stated plans of correction. Exercise overall responsibility and authority for developing, implementing, and managing the compliance, and internal audit programs for DHHA and DHMP. This position works with operations leaders, executives, board members, clinical staff, external government agencies and parties and legal counsel when appropriate.
Knowledge, Skills & Abilities
Education 1. Bachelor's degree required. 2. Juris Doctor or Master's degree in a related field preferred. Experience 1. Eight years' experience in healthcare regulatory, compliance and/or audit areas 2. Three years managerial experience required. 3. Demonstrated effectiveness operating in complex organizational environments. 4. Background in Medicare and Medicaid reimbursement and fraud and abuse laws. 5. Significant experience in the hospital and health insurance industry, with specific ethics/compliance program experience or legal experience in a hospital and/or health plan setting. Knowledge, Skills and Abilities 1. Excellent organizational and analytical skills. 2. Ability to work well both independently and with others in a matrix environment. 3. Strong project management skills and experience. 4. Strong acumen and understanding of healthcare, healthcare regulations, laws and governmental compliance program guidance. 5. Ability to perform detailed research and online searches of laws, regulations, industry best practices, and governmental guidance that might affect the organization's compliance practices, and translate regulatory requirements into terms readily understood by audiences at various levels of the organization and external clients. 6. Ability to effectively present and represent the health plan's interests externally with regulators. 7. Ability to effectively present information and respond to inquiries from employees, regulatory agencies, and others, as necessary. 8. Must have excellent data analysis and communication skills (verbal and written). 9. Strong analytical and organizational skills as well as problem-solving capabilities. 10. Ability to manage a diverse and demanding workload. 11. Ability to deal with a variety of abstract and concrete variables. 12. Strong and reliable judgment and discretion required. 13. Strong ability to independently and self-sufficiently identify, navigate and successfully resolve various compliance, risk management and regulatory issues. Certificates, Licenses and Registration 1. Certified Compliance professional (CHC or CCEP) or other nationally recognized certification preferred.
Work Type Full time
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, efficient, high-quality academic health care system that is considered a model for the nation. The Denver Health system includes the Rocky Mountain Regional Level I Trauma Center, a 525-bed acute care medical center, Denver's 911 emergency medical response system, 8 family health centers, 15 school-based health centers, the Rocky Mountain Poison and Drug Center, the Denver Public Health Department, an HMO, and The Denver Health Foundation.
As Colorado's primary safety net institution, Denver Health is a mission-driven organization that has provided more than $3.3 billion in care for the uninsured in the last ten years. Denver Health is a leader in performance and quality improvements and remains financially secure, in part, due to its nationally recognized implementation of lean principles in healthcare. Denver Health is a major resource to the community, serving approximately 185,000 individuals and 67,000 children a year.
Located just south of downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
"Denver Health is committed to provide equal treatment and equal employment opportunities to all applicants and employees. Denver Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class."
Internal Number: 1805
About Denver Health
Take your career to the next level at Denver Health, where we offer a robust benefits package and endless opportunities for growth. Denver Health is a nationally-ranked, locally-trusted, premier healthcare institution located in the heart of Denver, Colorado.Twenty-five percent of all Denver residents, or approximately 150,000 individuals, receive their health care here. We are known as an integrated health care system that encompasses multidisciplinary academic specialties, a community health system, a level I adult trauma center, pediatric emergency and urgent care center home to Denver Public Health and many of the nation’s leaders in medicine.