Director of Health Information/Corporate Compliance Officer

Health Information Director / Corporate Compliance Officer

Department: Health Information Management / Corporate Compliance
Reports To: Chief Information Officer (CIO)
FLSA Status: Exempt

Position Summary:  The Health Information Director/Corporate Compliance Officer is responsible for the leadership, administration, and oversight of the organization's Health Information Management (HIM) Department and Corporate Compliance Program. This position ensures the integrity, accuracy, confidentiality, security, and availability of resident health information while promoting compliance with all applicable federal, state, and local laws, regulations, accreditation standards, and organizational policies.

Reporting to the Chief Information Officer (CIO), this position serves as the facility Privacy Officer and is responsible for health information management, documentation integrity, coding, regulatory reporting, policy management, quality improvement, HIPAA compliance, and organizational compliance activities. The Director collaborates with executive leadership, physicians, ancillary providers, nursing, finance, quality, and regulatory agencies to support quality resident care and organizational excellence.

In the role of Corporate Compliance Officer, the incumbent works collaboratively with the Administrator, Executive Leadership Team, Compliance Committee, and Governing Body regarding compliance oversight, investigations, regulatory reporting, and organizational compliance initiatives

Essential Job Functions

Health Information Management

• Direct and manage all functions of the Health Information Management Department.
• Ensure resident medical records are complete, accurate, timely, and maintained in accordance with federal, state, and organizational regulations.
• Oversee the Electronic Health Record (EHR) system and ensure documentation integrity and compliance with established documentation standards.
• Review and verify the accuracy and completeness of active and discharged medical records prior to scanning or permanent electronic storage.
• Assign and maintain accurate ICD-10 coding for new admissions, readmissions, inpatient and outpatient therapies, and ongoing physician documentation to support reimbursement and regulatory reporting.
• Work collaboratively with the MDS and Finance departments to ensure accurate coding, billing, and reimbursement, including participation in the monthly Triple Check process.
• Maintain the facility census, accurately reflecting admissions, transfers, discharges, and census changes while preparing statistical reports as requested.
• Coordinate physician and ancillary provider scheduling, monitor required visits, obtain signatures, and ensure timely completion of documentation.
• Retrieve, process, and incorporate physician dictation and ancillary documentation into the resident medical record.
• Manage all Release of Information requests, including legal requests, subpoenas, insurance reviews, RAC, HEDIS, NGS, and other governmental or payer audits.
• Maintain medical records in accordance with record retention, storage, destruction, and confidentiality requirements.
• Prepare and submit all required state and federal reports, including but not limited to New York State Department of Health reporting, Health Commerce System submissions, Centers for Disease Control reporting, Death Certificate Registry, NYSIIS Immunization System, Case Mix reporting, and other mandated submissions.
• Compile, analyze, and report health information data to support Quality Assurance and Performance Improvement (QAPI) initiatives.
• Coordinate with all departments to collect, validate, and maintain operational and regulatory data.
• Provide referrals to outside agencies or facilities as needed to support resident discharge planning.
• Serve as the organization's Policy Coordinator by maintaining, updating, and coordinating policies and procedures across all entities.

Corporate Compliance

• Develop, implement, administer, and continuously improve the organization's Corporate Compliance Program.
• Promote a culture of ethical conduct, integrity, accountability, and regulatory compliance throughout the organization.
• Ensure compliance with CMS, Medicare, Medicaid, HIPAA, OSHA, New York State Department of Health regulations, state licensing requirements, and all other applicable federal and state laws.
• Serve as the facility Privacy Officer and oversee HIPAA Privacy and Security compliance.
• Conduct ongoing compliance risk assessments, internal audits, and monitoring activities.
• Investigate allegations of non-compliance, fraud, waste, abuse, privacy breaches, or unethical conduct and coordinate corrective action plans.
• Monitor the effectiveness of corrective action plans and recommend process improvements.
• Maintain the Compliance Hotline and reporting process.
• Monitor OIG, SAM, and applicable state exclusion databases in accordance with organizational policy.
• Coordinate organizational responses to regulatory surveys, audits, investigations, subpoenas, and requests for information.
• Prepare reports for executive leadership, the Governing Body, Compliance Committee, and QAPI Committee.
• Develop and provide education regarding the Code of Conduct, HIPAA, documentation standards, compliance expectations, and regulatory requirements.
• Assist leadership with internal investigations involving HIPAA, Corporate Compliance, documentation integrity, and regulatory concerns.

Leadership Responsibilities

• Serve as a member of the facility leadership team.
• Develop departmental goals, strategic initiatives, and performance improvement plans that support organizational objectives.
• Assist with departmental budgeting and resource planning.
• Collaborate with Nursing, Therapy, Admissions, Finance, Business Office, Infection Prevention, Quality, Human Resources, and other departments to promote regulatory compliance and quality resident care.
• Participate in survey preparation, mock surveys, plans of correction, and ongoing regulatory readiness activities.
• Attend leadership meetings, committee meetings, in-services, and educational programs as required.
• Travel between Community Wellness Partners campuses as necessary to perform assigned responsibilities.
• Perform other duties as assigned.

Qualifications

Education

• Associate's or Bachelor's Degree in Health Information Management, Health Administration, Nursing, Business Administration, or a related healthcare field preferred.

Licensure/Certification

• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred.
• ICD-10-CM coding certification or equivalent coding experience required.
• Certified in Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP) preferred.
• HIPAA Privacy certification preferred.

Experience

• Minimum of three (3) to five (5) years of progressively responsible experience in Health Information Management within a skilled nursing facility or long-term care setting.
• Experience managing Electronic Health Records, coding, documentation integrity, regulatory reporting, and reimbursement processes.
• Experience administering or supporting a healthcare compliance program preferred.

Knowledge, Skills, and Abilities

• Thorough knowledge of anatomy, physiology, medical terminology, ICD-10 coding principles, and long-term care documentation requirements.
• Comprehensive understanding of CMS, Medicare, Medicaid, HIPAA, OSHA, New York State regulations, and healthcare compliance requirements.
• Demonstrated ability to conduct audits, analyze regulations, interpret compliance requirements, and implement corrective actions.
• Excellent leadership, organizational, analytical, communication, and problem-solving skills.
• Ability to maintain confidentiality and exercise sound professional judgment.
• Proficiency with Microsoft Office applications and Electronic Health Record systems.
• Ability to work independently while effectively collaborating with interdisciplinary teams.

Physical Requirements

• Ability to sit, stand, walk, bend, reach, and move throughout the facility during the workday.
• Ability to lift, push, pull, or move up to twenty-five (25) pounds.
• Ability to use standard office equipment and computer systems.
• Ability to respond appropriately during emergency situations and assist as directed.

Working Conditions

• Office environment within a skilled nursing and rehabilitation organization.
• Frequent interaction with residents, families, physicians, interdisciplinary staff, auditors, surveyors, attorneys, and regulatory agencies.
• Occasional exposure to infectious diseases and other healthcare-related hazards; adherence to infection prevention and control practices is required.

Salary : $60,000 - $70,000