Vice President, Compliance & Risk Management

Responsibilities

• Develop, implement, and continuously improve the compliance program, policies, and procedures; align to OIG/CMS expectations and industry best practices.
• Establish and maintain an enterprise risk management approach that identifies, assesses, mitigates, and monitors key risks (clinical, operational, financial, regulatory, and reputational).
• Assist with federal/state surveys, audits, and oversight activities.
• Oversee intake, triage, and investigation of hotline reports, complaints, and potential violations; ensure consistent documentation, confidentiality, root cause analysis, and corrective action.
• Partner with Privacy and Information Security leaders on HIPAA/privacy incident management, breach risk assessments, mitigation plans, and required notifications.
• Build and manage a risk‑based annual work plan; oversee auditing and monitoring activities (e. g., EMTALA, billing/claims, documentation, patient rights, conflicts of interest) and track trends and outcomes.
• Drive development, implementation, and verification of corrective action plans; define owners, milestones, and effectiveness measures.
• Design and oversee compliance and risk training; promote speak‑up culture, non‑retaliation, and operational integration of compliance requirements.
• Prepare and present compliance/risk metrics, significant matters, and program updates to executive leadership, committees, and Boards; advise on risk tolerance and escalation decisions.
• Oversee development, review, and maintenance of compliance and risk‑related policies, standards, and guidance; ensure policies are operationalized and accessible.
• Collaborate on third‑party due diligence and contracting controls impacting compliance, privacy, and security obligations.
• In partnership with Legal and Risk, coordinate intake and tracking of litigation matters impacting the organization; support document retention and legal holds, discovery readiness, and collection of records; monitor trends, reserves/exposure (as appropriate), and remediation actions to reduce future risk.
• Partner with Legal, Quality/Patient Safety, and insurance partners on claim trends, event investigations, and risk mitigation strategies (as applicable to the organization).
• Recruit, develop, and lead a high‑performing team; establish goals, performance expectations, and a continuous improvement mindset.

Requirements

• Bachelor’s degree in healthcare administration, public health, risk management, law, or a related field (or equivalent experience).
• 10+ years of progressive experience in healthcare compliance and risk management (hospital, health system, or comparable regulated healthcare environment).
• Demonstrated knowledge of healthcare regulatory requirements and enforcement expectations (e. g., HIPAA/privacy, EMTALA, fraud/waste/abuse, billing/claims compliance, patient rights, accreditation/survey readiness, incident reporting).
• Experience leading investigations, audits/monitoring, and corrective action plans with measurable outcomes.
• Proven executive presence and ability to influence senior leaders and clinicians through clear, practical guidance.
• Strong written and verbal communication skills, including Board‑level reporting.
• Ability to handle sensitive matters with discretion and maintain confidentiality.
• #J-18808-Ljbffr