Professional Compliance Program Manager II
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Job Location:
Seattle, OR - USA
Yearly Salary:
$ 107431 - 161147
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Under the direction of the Professional Compliance Officer (CO) this role will develop and oversee key elements of the professional compliance program for Seattle Childrens employed and contracted providers including the Seattle Childrens Physician Network (SCPCN).
The role involves designing implementing and managing the SC professional compliance program to ensure that SC providers submitting professional claims adhere to applicable laws contractual obligations internal policies and ethical standards. This includes identifying and leading special compliance projects or investigations related to coding billing reimbursement and other regulatory matters.
The position contributes to the annual compliance work plan advises the CO on billing and coding matters and conducts research and analysis to support compliance decisions. This includes reviewing industry standards and facilitating consultations for policy development or process improvements.
Key operational functions include managing all components of the SC professional compliance program while personally performing some components such as annual audit ad hoc investigations as directed by the CO.
Additional duties include tracking resolutions identifying trends in compliance issues and participating in identification of solutions and system changes. The position also tracks OIG work plan issues and CMS billing compliance initiatives advising the CO on their impact.
The role may include presenting at board level meetings large group training and in interactions with the payer community. This position develops goals plans and metrics ensuring effective communication and implementation of initiatives.
Represent the Professional Compliance Officer as needed.
SERIES CONCEPT:
A program is a specialized area with specific complex components and discrete tasks which distinguish it from the main body of the organization. There is a defined plan to accomplish a particular objective with elements and scope that distinguish it from the usual scope and responsibilities of a department or functional area. The specialized tasks involve interpretation of policies procedures and regulations independent functioning and public contact. A program typically has a long-term focus with an expectation that the plan/program will serve or impact on-going needs or goals. The primary responsibilities and accountabilities are typically transferable from one program to another. The performance of administrative tasks are in support of the individuals performance specific to the program.
This is a hybrid remote position and must be based in Washington state.
Required Education and Experience
Bachelors degree in a related field or equivalent combination of education and extensive work experience
Five years experience in healthcare compliance or with progressive responsibility.
Four years of experience in healthcare management or a supervisory role working with cross-functional teams including analysis and reporting to deliver improved outcomes
Demonstrated experience leading projects teams and/or system improvements
Expert understanding of Federal and State healthcare statutes regulations and requirements for Federal healthcare programs particularly as they relate to professional fee billing including Teaching Physician Guidelines.
Experience preparing and presenting information to a variety of roles including providers managers and senior leaders in small or large group settings.
Required Credentials
Current Coding and/or Medical Records Certification (acceptable credentials include CCS-P CPC)
Preferred
Certification in Health Care Compliance (CHC)
Compensation Range
$107431.00 - $161147.00 per yearSalary Information
This compensation range was calculated based on full-time employment (2080 hours worked per calendar year). Offers are determined by multiple factors including equity skills experience and expertise and may vary within the range provided.
Disclaimer for Out of State Applicants
This compensation range is specific to Seattle positions located outside of Seattle may be compensated differently depending on various factors.
Benefits Information
Seattle Childrens offers a generous benefit package including medical dental and vision plans 403(b) life insurance paid time off tuition reimbursement and more. Additional details on our benefits can be found on our website Us
Hope. Care. Cure. These three simple words capture what we do at Seattle Childrens to help every child live the healthiest and most fulfilling life possible. Are you ready to engage with a mission-driven organization that is life-changing to many and touches the hearts of all #HOPECARECURE
Our founding promise to the community is as valid today as it was over a century ago: we will care for all children in our region regardless of the families ability to pay. Together we deliver superior patient care advance new discoveries and treatments through pediatric research and serve as the pediatric and adolescent academic medical center for Washington Alaska Montana and Idaho the largest region of any childrens hospital in the country.
U.S. News & World Report consistently ranks Seattle Childrens among the nations best childrens hospitals. For more than a decade Seattle Childrens has been nationally recognized in key specialty areas. We are honored to be one of the nations very best places to care for children and the top-ranked pediatric hospital in Washington and the Pacific Northwest.
As a Magnet designated institution we recognize the importance of hiring and developing great talent to provide best-in-class care to the patients and families we serve. Our organizational DNA takes form in our core values: Compassion Excellence Integrity Collaboration Equity and Innovation. Whether its delivering frontline care to our patients in a kind and caring manner practicing the highest standards of quality and safety or being relentlessly curious as we work towards eradicating childhood diseases these values are the fabric of our culture and community. The future starts here.
Our Commitment
Seattle Childrens welcomes people of all experiences backgrounds and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our patients and families. Our organization recruits employs trains compensates and promotes based on merit without regard to race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics.
The people who work at Seattle Childrens are members of a community that seeks to respect and celebrate all the qualities that make each of us unique. Each of us is empowered to be ourselves.
Seattle Childrens is proud to be an Equal Opportunity Workplace and Affirmative Action Employer.
Key Skills
- Project Management Methodology
- Project / Program Management
- Program Management
- Management Experience
- Microsoft Powerpoint
- Project Management
- Microsoft Project
- Budgeting
- DoD Experience
- Leadership Experience
- Supervising Experience
- Contracts
About Company
One of the best children's hospitals in the country, as ranked by U.S. News & World Report, Seattle Children's Hospital, Foundation and Research Institute advance pediatric care.
