Join a Legacy of Healing at Saint Joseph’s Hospital and Medical Center (SJHMC) in Phoenix, AZ, a 571-bed nonprofit founded by the Sisters of Mercy over 125 years ago. We're more than a hospital; we're a global destination for life-changing care, embracing patients with humankindness. Barrow Neurological Institute (BNI): A world-renowned center for groundbreaking neurological research and innovative treatments. Norton Thoracic Institute (NTI): A national leader in advanced thoracic care with pioneering surgical techniques. Level I Trauma Center: One of Arizona's busiest ERs, providing immediate, comprehensive care for critically injured patients 24/7. Culture of Excellence & Well-being: We care for our people, fostering professional and personal growth. Community & Collaboration: Be part of a network committed to global health and well-being. Join a Legacy, Shape a Future: Over 20% of our patients travel internationally for our specialized care.
Director Medicare Compliance Officer
Location
United States
Posted
11 days ago
Salary
$50 - $74 / hour
Seniority
Lead
No structured requirement data.
Job Description
Director Medicare Compliance Officer
St. Joseph Hospital & Medical Center
Role Description As the Medicare Compliance Officer (MCO) for Mercy Care Plan, managed by Aetna, a CVS Company, you will be the cornerstone of our Medicare Advantage (Part C) and Medicare Part D compliance efforts. This critical leadership role is responsible for: - Designing, implementing, and rigorously overseeing a comprehensive compliance program. - Ensuring unwavering adherence to all applicable federal and state regulations, as well as CMS requirements. - Safeguarding the integrity and operational compliance of all Medicare-related activities within Mercy Care Plan. - Cultivating a culture of compliance and ethical conduct. - Serving as a trusted advisor and strategic leader. - Maintaining strong daily operational alignment with the Medicare team. - Holding direct reporting accountability to the CEO and the Audit and Compliance Committee of the Board. - Delivering comprehensive formal reports to the Board, CEO, and Compliance Committee quarterly (or as needed) on program status, issue resolution, and oversight activities. - Overseeing the annual Board Code of Conduct and compliance training, including design, content, distribution, and tracking. - Developing mechanisms encouraging confidential reporting of suspected fraud, waste, abuse (FWA), or misconduct. - Promptly responding to FWA reports, coordinating internal investigations, developing corrective actions, and collaborating closely with Internal Audit and SIU. - Flexibly managing internal investigations and implementing corrective measures (e.g., policy enhancements, disciplinary actions) to ensure compliance and mitigate risk. Qualifications - Bachelors or an equivalent combination of directly related work experience and/or education. - Five (5) years of experience that demonstrates solid Medicare compliance program development, operation, and administration responsibilities. Requirements - None specified. Benefits - None specified. Company Description Join a Legacy of Healing at Saint Joseph’s Hospital and Medical Center (SJHMC) in Phoenix, AZ, a 571-bed nonprofit founded by the Sisters of Mercy over 125 years ago. We're more than a hospital; we're a global destination for life-changing care, embracing patients with humankindness. - Barrow Neurological Institute (BNI): A world-renowned center for groundbreaking neurological research and innovative treatments. - Norton Thoracic Institute (NTI): A national leader in advanced thoracic care with pioneering surgical techniques. - Level I Trauma Center: One of Arizona's busiest ERs, providing immediate, comprehensive care for critically injured patients 24/7. - Culture of Excellence & Well-being: We care for our people, fostering professional and personal growth. - Community & Collaboration: Be part of a network committed to global health and well-being. - Join a Legacy, Shape a Future: Over 20% of our patients travel internationally for our specialized care.
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