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PACE Southeast Michigan

Corporate Compliance Officer

PACE Southeast Michigan, Southfield, Michigan, United States, 48076

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Corporate Compliance Officer Join PACE Southeast Michigan as a Corporate Compliance Officer. The role involves overseeing and ensuring the organization adheres to all applicable federal and state laws, regulations, and internal policies. You will develop, implement, and maintain a comprehensive compliance program that addresses the seven essential elements of an effective compliance system.

Key Responsibilities

Develop, implement, and oversee the organization’s compliance program, ensuring adherence to federal and state laws, regulations, and internal policies.

Create and maintain clear and documented guidelines outlining expected behavior and compliance standards across the organization.

Appoint designated individuals responsible for overseeing the compliance program, including risk assessments, training, and investigations.

Conduct regular training sessions for all employees covering relevant compliance regulations, policies, and ethical conduct.

Establish open and accessible communication channels for employees to report potential compliance concerns without fear of retaliation.

Perform regular reviews and assessments to identify potential compliance risks and ensure adherence to policies.

Define and communicate disciplinary actions for violations of compliance policies to all employees.

Implement a system for timely investigation and corrective action when compliance issues are identified.

Conduct regular compliance audits to monitor adherence to policies and regulations; perform risk assessments to identify potential compliance vulnerabilities within the organization.

Analyze billing data and medical records to identify potential compliance issues.

Investigate complaints or suspected violations of compliance policies.

Report compliance concerns to senior management and the compliance committee (PACE SEMI Board of Trustees).

Communicate compliance updates and policy changes to relevant staff members.

Collaborate with legal counsel on complex compliance matters.

Promote a culture of compliance through open communication and employee engagement.

Work closely with various departments, including clinical operations, health plan management, finance, IT, and legal, to address compliance concerns.

Maintain relationships with regulatory agencies and stay updated on industry compliance trends.

Establish procedures for voluntarily self-reporting fraud or misconduct related to the PACE program to CMS and the State administering agency.

Required Skills & Qualifications

Bachelor’s degree in a healthcare‑related field (Master’s preferred).

Strong understanding of PACE and healthcare regulations, including HIPAA, Stark Law, Anti‑Kickback Statute, and Medicare/Medicaid guidelines.

5+ years of experience in compliance auditing and risk assessment methodologies.

Excellent communication and interpersonal skills to effectively train and educate staff.

Legal and analytical skills to interpret complex regulations and investigate compliance issues.

Ability to collaborate with diverse stakeholders within and externally.

Healthcare industry experience, preferably in a clinical or administrative role.

Seniority Level Mid‑Senior level

Employment Type Full‑time

Job Function Legal

Industries Hospitals and Health Care, Individual and Family Services, Hospitality

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