No matter what your job title, the work you do at Kaiser Permanente Georgia supports the health and well-being of our Atlanta-area members. That's because each of us-from our financial professionals and IT team members to our RNs and physicians on the front line of care-shares a commitment to providing the best possible care experience. Come build a rewarding career in an environment that supports your success. Join us and put your beliefs into practice.

The Compliance Operations and Care Delivery Director assumes a strategic leadership role in the oversight of care delivery and operational compliance within KPGA, the span of which includes clinical, scope of practice, clinical coding, revenue cycle, and quality compliance. This position ensures the organization's ongoing compliance with federal and state regulatory requirements, internal policies and procedures, and accreditation standards. This position is responsible for implementation of regional compliance program elements as well as providing compliance guidance to departmental leaders. He/She supervises assigned staff.

Essential Functions:
- Provide leadership and guidance to operational leaders regarding oversight activities across regional work teams & processes.
- Develops and establishes effective means of interdepartmental communication and coordination of compliance activities both directly and through the appropriate committee structures.
- Collaborates with key leaders and various work groups to ensure national and regional compliance initiatives are implemented.
- Oversees and provides strategic direction on clinical area risk assessments and audits within the region to measure compliance with state and federal laws and accreditation standards.
- Responsible for project tracking, analysis, and identification of deficiencies and oversight of corrective actions. Partners with Quality leaders to support clinical accreditation and licensure.
- Conducts investigations related to clinical compliance concerns, in partnership with the Fraud, Waste and Abuse Prevention Manager & Human Resources representatives.
- Provides guidance to Regional department lead in developing policies, operational procedures, and practices that are compliant with the relevant state, federal, accrediting & KP regional & national policy requirements.
- Serves as the primary liaison for compliance department on Care Delivery committees formed by NCO.
- Chairs the regional Scope of Practice Committee.
- Provides oversight of the region's annual risk assessment process.
- Prepares compliance reports to present to senior leadership, NCO and, when necessary, regulatory agencies.
- Working closely with Legal and various operational areas, monitors and evaluates regional clinical departments'/functions' compliance with law, accreditation standards, internal policies and procedures.
- Serves as a representative of the VP of Regional Compliance and link between the VP and the health care delivery system committees which address compliance issues.
- Manages and develops staff within the department. Coaches staff on individual development opportunities.
- May perform additional duties as assigned.

Basic Qualifications:
- BA/BS degree in related field (e.g. health care, business).
- Current health care compliance certification (CHC) through the Health Care Compliance Association (HCCA) is required.
- Minimum of 8 years of escalating experience in the health care field.
- Significant experience in managing large and complex projects.
- Minimum of 5 years of direct management/leadership experience.
- Experience in collection, maintenance, and display of data.
- Excellent written and oral skills and effective time management experience. Writing samples will be required from all final candidates.
- Ability to conduct investigations and interviews in a professional and comprehensive manner.
- Ability to manage complex reporting structures.
- Ability to manage multiple priorities and projects and meet deadlines.
- Demonstrated ability to work independently and to motivate people to achieve shared goals.
- Results-oriented, analytical and creative thinker with the highest level of personal integrity.
- Strong attention to detail is mandatory for success in this role.


Preferred Qualifications:
- MA/MS degree in health care or related field (or equivalent years of experience).
- Prior experience with Kaiser Permanente.
- Prior health care compliance experience.
- Experience working with clinical staff.
- Health care compliance certification (CHC).



Primary Location: Georgia-Atlanta

Scheduled Hours (1-40): 40

Shift: Day

Working Days: Mon - Fri

Working Hours Start: 8:00

Working Hours End: 5:00

Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group: None

Job Level: Director/Senior Director

Job: Compliance / Privacy / Regulatory

Public Department Name: Corporate Compliance

Travel: No

Job Eligible for Benefits: Yes

External hires must pass a background check/drug screen. We are proud to be an equal opportunity/affirmative action employer.