Corporate Compliance Officer at Coralvita

Irving, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

21 Jul, 26

Salary

0.0

Posted On

22 Apr, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Healthcare compliance, Regulatory compliance, LTACH regulations, IRF regulations, CMS conditions of participation, Auditing, Risk management, Policy development, Staff training, Incident investigation, Stark law, Anti-kickback statute, False claims act, Data analysis, Communication, Leadership

Industry

Environmental Services

Description

The Corporate Compliance Officer (CCO) is responsible for developing, implementing, and overseeing the organization's compliance program across its Long-Term Acute Care Hospital (LTACH) and Inpatient Rehabilitation Facility (IRF) operations. The CCO serves as the primary liaison between facility operations, legal counsel, regulatory bodies, and executive leadership to ensure adherence to all applicable federal and state laws, regulations, and internal policies. This is a senior leadership role requiring independent judgment, strong communication skills, and deep expertise in post-acute and specialty hospital regulatory requirements. Key Responsibilities Program Oversight & Development * Design, implement, and maintain a comprehensive corporate compliance program consistent with OIG guidelines, CMS Conditions of Participation (CoPs), and industry best practices. * Develop and regularly update compliance policies, procedures, and the Code of Conduct. * Establish and monitor annual compliance work plans with measurable objectives and risk-based priorities. * Lead the Compliance Committee and report program status and findings to the Board of Directors and executive leadership. Regulatory Compliance – LTACH & IRF Specific * Ensure compliance with LTACH-specific criteria, including average length of stay (ALOS) requirements, patient criteria (25-day rule), and CMS site-neutral payment policies. * Oversee adherence to IRF coverage criteria including the 60% Rule (Compliant Patient Criteria), required physician oversight, and individualized overall plan of care (IPOC) documentation standards. * Monitor compliance with Medicare and Medicaid billing and reimbursement rules specific to LTACH and IRF Prospective Payment Systems (PPS). * Stay current with CMS transmittals, Final Rules, and OIG Work Plans relevant to LTACH and IRF settings. Auditing & Monitoring * Direct internal auditing activities including medical record reviews, billing audits, and documentation audits for LTACH and IRF criteria compliance. * Oversee third-party compliance audits and coordinate responses to Recovery Audit Contractor (RAC), MAC, CERT, and ZPIC/UPICs reviews. * Analyze audit findings, identify trends, and implement corrective action plans (CAPs). * Monitor outcomes of CAPs to ensure sustainability and effectiveness. Training & Education * Develop and deliver compliance training programs for clinical, coding, billing, and administrative staff. * Ensure new employee compliance orientation and annual refresher training completion. * Create targeted education based on audit findings, regulatory changes, and identified risk areas. Investigations & Reporting * Manage the confidential compliance hotline and investigate all reported compliance concerns promptly and thoroughly. * Conduct root cause analyses and coordinate corrective actions in partnership with HR, Legal, and Operations. * Oversee voluntary self-disclosure obligations and coordinate with legal counsel on government investigations or inquiries. * Maintain accurate and confidential records of all compliance investigations. Risk Management * Conduct and document annual compliance risk assessments across LTACH and IRF operations. * Identify emerging regulatory risks and proactively communicate risk mitigation strategies to leadership. * Collaborate with Revenue Cycle, Clinical Operations, and Case Management teams to address billing and documentation vulnerabilities. Government & Regulatory Relations * Serve as the primary point of contact for CMS surveys, state health department surveys, and accreditation reviews (e.g., The Joint Commission, DNV). * Coordinate responses to Medicare Administrative Contractor (MAC) correspondence and government contractor reviews. * Maintain relationships with legal counsel, industry associations, and regulatory bodies. Qualifications Education * Bachelor's degree required in healthcare administration, nursing, health information management, business, or a related field. * Master's degree (MHA, MBA, MSN, JD) strongly preferred. Licensure & Certification * Certified in Healthcare Compliance (CHC) through the Health Care Compliance Association (HCCA) required, or must obtain within 12 months of hire. * Additional certifications such as CHPC, CPCO, RHIA, CCS, or CPC preferred. Experience * Minimum of 5–7 years of progressive healthcare compliance experience required. * Direct experience with LTACH and/or IRF regulatory requirements strongly preferred. * Prior experience managing corporate or multi-facility compliance programs preferred. * Familiarity with CMS Conditions of Participation, IRF-PAI, and LTACH PPS billing strongly preferred. Skills & Competencies * In-depth knowledge of federal and state healthcare regulations, OIG guidelines, Stark Law, Anti-Kickback Statute, and False Claims Act. * Strong analytical skills with the ability to interpret complex regulatory guidance and apply it operationally. * Excellent written and verbal communication skills, including the ability to present findings to Boards and C-suite leadership. * Demonstrated ability to build collaborative relationships across clinical, operational, and administrative departments. * High degree of integrity, discretion, and professional judgment. * Proficiency with compliance management software, EHR platforms, and Microsoft Office Suite. Reporting Structure This position reports directly to the Chief Executive Officer (CEO) and has a dotted-line reporting relationship to the Board of Directors / Compliance Committee. The CCO has supervisory responsibility over compliance staff and works in close partnership with Legal, Revenue Cycle, Clinical Operations, and Human Resources. Working Conditions * Full-time, exempt position. * Travel required to facility locations as needed (estimated up to 25–30%). * Hybrid or on-site work arrangements dependent on organizational needs.

Responsibilities

The Corporate Compliance Officer develops and oversees the organization's compliance program for LTACH and IRF operations to ensure adherence to federal and state regulations. They lead compliance committees, conduct internal audits, manage investigations, and serve as the primary liaison with regulatory bodies.