VP & Compliance Officer - Full Time - Wolf River

Job Title: VP & Compliance Officer

About Us

At West Cancer Center, we are committed to providing exceptional, patient-centered cancer care while maintaining the highest standards of integrity, accountability, and regulatory compliance. Our leadership team works collaboratively to promote ethical conduct, identify and address compliance risks, and support an effective compliance program throughout the organization.

Position Overview

The VP & Compliance Officer is a key member of West Cancer Center’s leadership team and provides independent and objective leadership of the organization’s healthcare compliance program. This position is primarily responsible for the establishment, implementation, operation, and continuous improvement of the compliance program and is accountable for its effectiveness.

The VP & Compliance Officer oversees the identification, assessment, monitoring, investigation, and remediation of compliance risks and serves as a resource and advisor to the Chief Executive Officer, senior leadership, providers, employees, and other stakeholders regarding compliance matters. This position also serves as West Cancer Center’s primary HIPAA Privacy Officer and oversees the privacy compliance program.

Key Responsibilities

Compliance Program

Serve as the primary leader and accountable owner of West Cancer Center’s healthcare compliance program

Establish, maintain, and continuously improve an effective compliance program consistent with applicable laws, regulations, regulatory guidance, and recognized compliance practices

Conduct or oversee annual compliance risk assessments and develop risk-based compliance work plans

Identify compliance risks and recommend appropriate controls, education, monitoring, and risk mitigation strategies

Establish compliance metrics and reporting processes to evaluate program effectiveness

Policies, Education, Auditing & Monitoring

Develop, review, implement, and maintain compliance policies and procedures in collaboration with appropriate leaders and subject matter experts

Oversee compliance education and training and promote ethical conduct, regulatory awareness, and non-retaliation

Develop and oversee risk-based compliance auditing and monitoring, including billing, coding, documentation, reimbursement, medical necessity, provider arrangements, privacy, and other identified risk areas

Coordinate responses to governmental, regulatory, accreditation, payer, and other external audits or inquiries

Evaluate audit and monitoring results and oversee appropriate compliance remediation

Investigations & Remediation

Receive and evaluate reports indicating potential violations of healthcare laws, regulations, regulatory requirements, or conduct that may create significant compliance risk

Conduct or oversee compliance investigations and coordinate with Human Resources, operational leadership, or other appropriate parties as needed

Evaluate the scope, root cause, and potential impact of substantiated compliance concerns

Develop and monitor compliance remediation plans addressing regulatory violations, process deficiencies, control weaknesses, and systemic risks

Recommend improvements to policies, procedures, controls, workflows, education, and monitoring to mitigate risk and prevent recurrence

Escalate significant or unresolved compliance concerns to the Chief Executive Officer

Coordinate with Human Resources when a compliance investigation identifies employee misconduct directly related to the compliance concern; Human Resources retains responsibility for determining and administering disciplinary or other employment action

Regulatory Compliance, Fraud, Waste & Abuse

Monitor and communicate changes in applicable healthcare laws, regulations, regulatory guidance, and enforcement priorities

Provide compliance guidance to leadership, providers, and departments regarding regulatory requirements and identified risks

Oversee compliance activities related to fraud, waste, and abuse, including applicable requirements under the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, and Medicare and Medicaid programs

Coordinate appropriate investigation, remediation, reporting, disclosure, and repayment activities when potential fraud, waste, or abuse is identified

HIPAA Privacy

Serve as West Cancer Center’s primary HIPAA Privacy Officer and oversee the privacy compliance program

Monitor compliance with HIPAA Privacy, Security, and Breach Notification requirements

Oversee privacy complaints, suspected unauthorized access, use or disclosure of protected health information, and potential breaches

Provide guidance regarding the appropriate use and disclosure of protected health information and coordinate investigation, mitigation, documentation, and required reporting of privacy incidents

Leadership & Governance

Provide regular reports to the Chief Executive Officer, senior leadership, and/or applicable Board committee regarding significant compliance risks, investigations, audit findings, remediation, and program effectiveness

Provide independent and objective advice regarding significant compliance risks and emerging regulatory issues

Participate in appropriate leadership, governance, risk, privacy, quality, and other committees

Maintain appropriate independence and access to records, systems, personnel, and information necessary to fulfill compliance responsibilities

Foster a culture in which compliance concerns are identified, reported, investigated, and appropriately addressed

Qualifications

Education & Experience

Required:

Bachelor’s degree in Business, Healthcare Administration, Compliance, or a similar field

Minimum of five (5) years of progressive healthcare compliance or related experience

Experience administering a healthcare compliance program, including risk assessment, auditing, monitoring, investigations, and remediation

Experience working with physicians, executive leadership, employees, and governing bodies

Preferred:

Master’s degree, JD, or other relevant master’s degree

Credential/Licensure

Preferred:

Certified in Healthcare Compliance (CHC), CHPC, CHRC, CCEP, CIA, CPC, or other compliance, auditing, or privacy credential

Knowledge, Skills & Abilities

Strong knowledge of healthcare laws, regulations, regulatory requirements, compliance principles, HIPAA, and fraud, waste, and abuse requirements

Knowledge of healthcare billing, coding, documentation, reimbursement, medical necessity, and related regulatory risks

Strong analytical, investigative, critical-thinking, and problem-solving skills

Excellent written and verbal communication skills, with the ability to explain complex regulatory requirements to diverse audiences

Demonstrated integrity, sound judgment, discretion, independence, and objectivity

Ability to identify and appropriately address compliance risks and challenge practices when warranted

Ability to manage confidential and sensitive information

Ability to work effectively with physicians, providers, executives, managers, employees, and external regulatory and oversight entities

Work Environment & Physical Demands

Physical activities may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion

Must have good balance and coordination

Light work requiring exertion of up to 25 pounds of force occasionally and/or up to 10 pounds of force frequently

Close visual acuity is required for activities such as preparing and analyzing data and figures, transcribing, viewing a computer terminal, and extensive reading

The position is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work

Why West Cancer Center is a