Corporate Counsel and Compliance Officer

• Act as the Compliance Officer for Vail Health Services and all Vail Health Services affiliates (together referred to as “VHS”), including serving as a liaison to the VHS Board and Board Committees on compliance-related matters.

1. Provides guidance on billing, coding, and other reimbursement matters for compliance with government and commercial health plan requirements.
2. Provides counsel on health care laws including those on privacy, Medicare, Medicaid and other government programs, fraud and abuse, physician self-referral and anti-kickback laws, and EMTALA.
3. Negotiates, drafts, and reviews contracts and other legal documents, including physician services, corporate transaction documents, real estate leases, and affiliations.
4. Lead the development, implementation, maintenance, and enforcement of the VHS compliance program, standards of conduct and related policies and procedures as part of a cross-sectional team. Work closely with the Information Security Officer (ISO) to develop, implement and oversee information security-related policies and procedures.
5. In collaboration with team members, develops compliance policies and procedures, and works closely with compliance to investigate and resolve compliance concerns
6. Work with team members to develop an effective compliance/privacy education and training program for VHS and affiliated health care providers, including, for example new employee orientation, annual on-line training and department specific training.
7. Help establish and maintain a compliance/privacy reporting process that allows employees to report without retaliation.
8. Provides guidance on revenue cycle matters, including collection and third-party liability issues.
9. Performs legal and factual research necessary to draft and analyze various contracts, policies, and other documents and to advise internal clients.
10. Assists the CLO and other team members with the management of risk and litigation-related matters, including the engagement and direction of outside counsel.
11. Develop annual compliance work plans for VHS and report findings and recommendations to appropriate leadership, including as appropriate progress reports to the VHS Board of Directors and Board Committees.
12. Receive, investigate, document and track compliance -related complaints from workforce members, patients and/or family members, the compliance hotline or other sources; analyze contributing factors and trends and facilitate process improvements.
13. Work with team members to conduct breach risk assessments for impermissible disclosures, maintain log and submit required reporting to U.S. Department of Health and Human Services (HHS).
14. Coordinate organizational response to HHS Office of Civil Rights (OCR) and other federal and state entities, in any compliance/privacy program audits, inquiries or investigations.
15. Collaborate with team members and the ISO regarding auditing and monitoring of employees and business associate’s inappropriate access and/or disclosure of protected health information; conduct routine privacy monitoring and auditing, including periodic HIPAA walkthrough audits.
16. Conduct auditing and monitoring, and may direct that billing processes be suspended if necessary, to ensure compliance.
17. Ensure that all credible deviations from policies and procedures or suspected violations of the state and federal laws and regulations are investigated.
18. Collaborate with Human Resources to ensure the enforcement of compliance program standards.
19. Assists in promoting efficiency of the Legal, Risk, and Compliance departments by preparing templates, forms, outlines, instructional materials, and other tools and resources.
20. Perform other duties as assigned in compliance with HIPAA.
21. Role models the principles of a Just Culture.

• 5 years of progressively responsible experience within a health care environment that includes experiences in advising on a broad range of legal matters and planning and implementing projects that affect multiple departments and functions; implementing regulatory changes; auditing in a regulatory or compliance setting; identifying, investigating, and resolving compliance and revenue cycle issues; and analyzing and interpreting regulatory requirements. 
• Knowledge of processes related to billing, including but not limited to Local and National Coverage Decisions, Advanced Beneficiary Notices, Medicare Secondary Payor questions, write-offs, and chargemaster management.
• Experience advising hospitals and other health care providers on a broad range of health law, specifically on Medicare/Medicaid billing issues and appeals.
• Extensive knowledge of laws and accreditation standards governing the delivery of healthcare by providers and suppliers, including hospitals, physicians, and ambulatory surgery centers.
• Experience in fraud and abuse, physician self-referral, anti-kickback, privacy, billing and reimbursement, and patient care issues.
• Experience working with or managing outside counsel in litigation-related matters, including working with insurance carriers.
• Strong computer, problem-solving and analytical skills, including ability to perform data mining to identify aberrant patterns of billing and documentation. Demonstrated personal traits of a high level of motivation, team orientation, professionalism and trustworthiness, and placing a high value on treating others with dignity and respect. Strong written and oral communication skills.
• Strong skills in personal diplomacy with demonstrated ability to handle sensitive communications with leadership, physicians, staff, management, outside legal counsel and regulatory agencies.

• Admission (or eligibility for admission) to the Colorado Bar

One of the following certifications is preferred:

• Certified in Healthcare Compliance (CHC) by Health Care Compliance Association (HCCA)
• Certified in Healthcare Privacy Compliance (CHPC) by Health Care Compliance Association (HCCA)
• Certified in Health Care Privacy and Security (CHPS) by American Health Information Management Association (AHIMA)
• Certified Coding Specialist (CCS) by American Health Information Management Association (AHIMA)
• Registered Health Information Technician (RHIT) by American Health Information Management Association (AHIMA)
• Registered Health Information Administrator (RHIA) by American Health Information Management Association (AHIMA)

• Demonstrated proficiency using Microsoft Office (Word, Excel, and PowerPoint) or similar products

• Juris Doctor, required

The posted salary range for this position applies to Colorado and may be adjusted based on geographic location. Vail Health considers a variety of factors in making compensation decisions, including but not limited to experience, education, licensure and/or certifications, geographic location, market demand and other business and organizational needs. 

Benefits at Vail Health (Full Time) Include:

• Competitive Wages & Family Benefits:
  • Competitive wages
  • Parental leave (4 weeks paid)
  • Housing programs
  • Childcare reimbursement 
• Comprehensive Health Benefits: 
  • Medical
  • Dental 
  • Vision
• Educational Programs: 
  • Tuition Assistance 
  • Existing Student Loan Repayment
  • Specialty Certification Reimbursement
  • Annual Supplemental Educational Funds
• Paid Time Off:
  • Up to five weeks in your first year of employment and continues to grow each year.
• Retirement & Supplemental Insurance:
  • 403(b) Retirement plan with immediate matching 
  • Life insurance
  • Short and long-term disability
• Recreation Benefits, Wellness & More:
  • Up to $1,000 annual wellbeing reimbursement
  • Recreation discounts
  • Pet insurance