Our featured candidates have a wide range of experience in Compliance, Privacy, Security, Risk, Audit and Quality.
The profiles below are a representation of the exceptional Healthcare Compliance professionals in our network. They have diverse backgrounds and varying levels of experience.
Please visit us often as our spotlight profiles are updated regularly. Feel free to contact us if you have any questions.
This candidate’s career has progressed in Compliance for 15+ years. This candidate’s career in Compliance began as Hospital Compliance Coordinator (Manager). Since then this candidate has held positions as Regional Compliance and Privacy Officer, Divisional Compliance & Privacy Officer, Regional Vice President, Compliance & Privacy Officer and Chief Compliance Officer at health systems and a managed care organization.
This candidate is a collaborative and supportive, hands on leader, looked to as a resource. This candidate is fiscally responsible, has written policies and is a polished executive level presenter.
This candidate has worked under multiple Corporate Integrity Agreements, working with the Office of Inspector General and successfully meeting the requirements of all the CIAs without any further fines or penalties.
This candidate is thorough and adept at audit, and has been able to catch and rectify billing errors, avoiding further auditing by the OIG and avoiding a potential CIA.
This candidate has a deep breadth and depth of experience with hospital contracting and led the implementation of a third party contract management database used for all vendor and referral source contracting, centralizing all contracts under on system which created efficiencies, reduced costs and increased savings for the health system.
This candidate has an MBA, a BA, and is certified in Compliance and in Risk Management. This candidate is also White and Yellow Belt Certified.
This candidate is a bright and accomplished healthcare compliance professional with well-rounded experience overseeing compliance in hospitals, physician groups, third party billing companies and ambulatory services. This candidate is currently serving as Compliance Officer at a large health system, overseeing multiple entities. This candidate also has a great breadth and depth of experience overseeing tertiary/quaternary medical center (4500+ employees), Revenue Cycle Services/Patient Contact Center (2000+ employees) and Ambulatory Surgery Centers (700+ employees spanning a several locations).
This candidate enjoys leading teams and growing programs, particularly at their early stages, as the candidate feels it provides an opportunity for growth. This candidate also enjoys leading mature programs as it enables the candidate to work on effectiveness while fostering a culture of ethics and compliance!
Among this candidates accomplishments was recapturing over $400K in revenue by identifying a coding opportunity within a hospital department, bridging the gap between Revenue Cycle, Coding & Operations and correcting the coding where significant write-offs were occurring.
This candidate has a Bachelor of Science in Business Administration and a CHC Certification.
This candidate has held Director roles in a variety of settings, including a large academic medical center, a large non-profit health system, a Revenue Cycle services company and has Big 4 Consulting experience. This candidate has a diverse and exceptionally unique and valuable background with experience in both Healthcare Regulatory Compliance and Revenue Cycle Operations. This candidate has strong substantive knowledge in Coding, Clinical Documentation, HIM and Revenue Integrity, Billing Compliance, Audits, Investigations and CMS Teaching Physician Rules.
This candidate is a strong leader and collaborator across integrated departments and teams and has successfully implemented and managed ICD-10 Project operations. This candidate especially enjoys research, policy development, investigations and educating on regulatory requirements. This candidate is receptive to working remotely and to travel.
This candidate has RHIA, CPC, CHC and CDIP certifications as well as a Bachelor of Science Degree in Health Information Management.
This exceptionally experienced candidate has worked on both the payor and provider side, and possesses an especially strong background leading compliance at very large (1000+ physicians), multi-state physician group practices, as well as out-patient and ambulatory services. This candidate is poised and ready to step in and manage a Compliance Program at most any large physician group practice.
This candidate has experience managing large groups as well as being a sole contributor. This candidate has built multiple compliance programs from the ground up and has successfully worked with the Department of Justice and the OIG to help negotiate a settlement or dismissal of a Qui Tam case.
This candidate has a Bachelor’s Degree in Management and is working on completion of a graduate degree.
This candidate is receptive to Interim Compliance positions and is an optimal choice while an organization is searching for a permanent CCO. This candidate is an exceptional Compliance Officer who is equipped and able step into a healthcare organization undergoing an audit or having to implement a Corrective Action Plan to support the Compliance program during a period of transition.
This candidate is an attorney who is an experienced, tech savvy, healthcare compliance and operations professional. This candidate’s background includes extensive work with Managed Care Organizations, Health Insurance Exchanges, Accountable Care Organizations, a Third Party Administrator, as well as government healthcare programs, health systems and provider groups.
This candidate is especially skilled with assisting organizations through Corporate Integrity Agreement implementation and compliance.This candidate has direct experience with successfully implementing the major components of a CIA for a managed care organization, helping it to avoid further financial penalties and reputational harm. In addition, this candidate has been responsible for continuing oversight to ensure ongoing compliance with the terms of the CIA. This candidate has also been recruited specifically to assist organizations with corrective action plans, restructuring, and with growth initiatives.
This candidate has strong technology skills and successfully designed a major compliance solution which served as a compliance tool to enhance monitoring and tracking of Medicare Advantage and Medicaid compliance, which became a core component of a companywide compliance program. This not only increased the compliance efficiency for internal monitoring and oversight, but reduced the cost of external auditing conducted by the Independent Review Organization retained to report to the OIG quarterly.
In addition to this candidate having a JD, this candidate also had a CHC.
This candidate is an experienced leader overseeing the regional, “in the field” Compliance professionals for a healthcare system consisting of multiple hospitals and a large physician group. This candidate is ready to take the next step and join a larger health system, continuing to oversee and mentor a team of compliance professionals.
This candidate reorganized the system’s Compliance Department creating an organization that has increased visibility and compliance effectiveness with minimal increase in expenses. The system now has Compliance professionals based in the hospitals and physician practices who are responsible for working with management to integrate compliance into operations on a daily basis.
In addition to acute care hospital experience, this candidate also has experience with rehabilitation, long-term care, home health, hospice and physician services. This candidate also has Big 4 consulting experience. This candidate is a CPA and has a CHC.
This candidate is a high level compliance leader and RN with experience in the health insurance compliance and operations space, as well as on the provider side. This candidate is poised to bring the background and skill gained in managed care, operations and clinical nursing to a provider environment, with the goal of enhancing processes and improving quality and regulatory adherence, to protect and serve beneficiaries/patients.
This candidate is ready to step into position in which there’s responsibility to shape the compliance program, bring ethical considerations to bear where appropriate, provide support and guidance to staff and institute or maintain a collaborative relationship of trust between departments, staff and Compliance so that together excellence in service is provided. This candidate is experienced with start-up compliance programs, as well as those that need to be refocused or overhauled. This candidate is a true leader and especially enjoys mentoring and guiding compliance staff while helping them grow professionally in a collaborative and supportive environment.
In addition to being an RN, this candidate has a Master’s Degree in Health Services Administration and has a CHC.
This candidate is an experienced healthcare executive currently serving as the compliance officer and member of the senior leadership team for a medical group with over 800 providers in addition to serving as the compliance officer for other outpatient and inpatient entities within a regional market for a large healthcare system. This candidate leads a team of compliance professionals, develops and implements strategic initiatives, and sets forth operational compliance tactics to ensure the compliance program is highly effective and dynamic. This candidate has experience as a critical care and emergency department RN, hospital attorney, risk manager, healthcare compliance consultant and over ten years of compliance officer and leadership experience.
This candidate has held leadership positions at both non-profit and for-profit large national healthcare systems. This candidate has strategic planning experience for integrated healthcare delivery systems, has developed risk assessment tools, risk mitigation plans, compliance education programs and successfully led complex investigations. This candidate has experience and knowledge related to Stark law, the False Claims Act, and HIPAA, prepared Self Disclosure submissions, handled large privacy and security breaches, responded to government inquiries, improved vendor management and screening processes, and developed successful tactics to manage potential conflicts of interest.
This candidate has extensive experience in delivering presentations to Boards and senior leadership. This candidate has a passion for dynamic education and understands the complexities and operational processes of integrated healthcare systems.
In addition to having a JD, this candidate is an RN and is CHC certified.
This candidate is engaging and likeable with the skills needed to develop productive key relationships and to quickly improve a culture of Compliance and Ethics. This candidate is currently serving as the Chief Compliance Officer of a health system. In addition to an acute care hospital, this candidate is also responsible for the hospital’s ancillary facilities, skilled nursing facilities, numerous physician practices, and Enterprise Risk. This individual thoroughly enjoys Health Care Compliance, Ethics, and Risk Management and would like the opportunity to have increased responsibilities at a larger hospital or system.
This candidate has successfully repaired the hospital’s culture which was generally fearful and intimidated of reporting Compliance and Ethics matters. That culture existed prior to this candidate’s arrival. When this candidate began the role, the candidate worked with management to implement a Culture of Compliance assessment and strategy. The assessment showed that a sizable number of employees at the organization were fearful of reporting and had faced actual intimidation by supervisors and managers. Over one third of this candidate’s organization did not know how to effectively report a Compliance issue. Within one year, most employees know this candidate by first name, management has become more trusting of Compliance, Compliance reports come in frequently, and the most recent survey showed that the fear of reporting was cut by nearly 50% and the lack of knowledge of reporting cut by over 75%.
This candidate has also reformed a weak Risk Assessment process. This candidate worked with a team to reform the process, roll out an Enterprise Risk System, and identify over 1300 risks in their assessment. Over 100 high-risk items were identified to fix within 120 days and successfully mitigated. This challenge brought over 40 service lines together to solve problems that could impact the entire system.
This candidate has also been able to successfully digitalize processes in a cost effective manner; obtain the buy-in of leadership in the digitalization of numerous screening processes; and engage in successful operational compliance, ethics, and risk management during times of crisis and significant organizational exposure. These efforts have increased the efficiency of the program, the ability to pull data with a click of a mouse, and has made this candidate a key player in numerous operational areas. This individual continues to work with their team to finds ways to eliminate paper, go digital, and streamline processes.
This candidate has a J.D., a Bachelor of Arts in Political Science, is Certified in Healthcare Compliance (CHC), and trained in Lean Six Sigma.
This candidate has extensive experience in healthcare law, Compliance & Privacy. This candidate has served as a Compliance Officer & Privacy Officer as well as an Associate General Counsel, providing for well-rounded background.
This candidate is well-versed in healthcare regulatory issues; HIPAA privacy and security, Stark Law, Anti-Kickback Statute, False Claims Act, and federal labor laws.
This candidate successfully laid the foundation for the integration of two compliance programs following an acquisition of a large healthcare organization by the candidate’s organization. This candidate developed a system for regular visits to the organization’s hospitals to increase awareness of the compliance program. This candidate oversaw the implementation of a computer-based annual conflicts of interest survey tool, and revised and overhauled HIPAA compliance policies. Under the candidate’s leadership, HIPAA training was expanded and a quarterly compliance newsletter was developed and regularly published. This candidate has also been able to increase cooperation and integration of the privacy office with the CISO.
In addition to having a J.D., this candidate is also certified in Healthcare Compliance.
This candidate is an exceptionally experienced Compliance and Privacy Officer; he’s both an attorney and a CPA and has a Master’s Degree in Health Policy and Management. He’s very well-tenured and is responsible for the development and maintenance of the General Counsel, Corporate Compliance and Internal Audit functions at a 300+ bed nonprofit hospital.
This candidate established and developed the hospital’s Medicare, Medicaid and HIPAA Compliance programs as well as the hospital’s first internal audit function and provides ongoing training to the members of the board, medical staff and employees.
This candidate’s accomplishments include the successful conclusion of two qui tam actions brought against his organization without any further action, demand or sanction by federal or state government against the organization including, but not limited to imposition of a Corporate Integrity Agreement. This outcome was the result of both the federal and state government’s recognition of the effectiveness of the organization’s Corporate Compliance Program which he established. He also developed and established an in-house general counsel function which resulted in a significant reduction in fees paid to outside counsel and consultants for legal and compliance services.
This candidate is an attorney and experienced mediator with a broad depth and breadth of experience in academic institution research compliance as well as a strong consulting background. This candidate’s leadership roles range from rather narrow programmatic issues such as revising compliance policy and procedure to Institution wide concerns such as safety, accreditation, strategic planning and diversity committees. The candidate has also managed teams in both supervisory and chair capacities.
This candidate feels comfortable with traditional hospital compliance as well as research compliance and has also worked in hospitals and has litigated and mediated healthcare issues in both tort/malpractice arenas and regulatory concerns. The candidate is comfortable with regulatory interpretation and has represented clients before regulatory boards.
This candidate is an experienced trainer, presenter and educator. The candidate presents information about compliance, research integrity and regulatory interpretations to groups of students and faculty, to college wide assemblies of faculty, and to regional groups of professionals, with audiences ranging from 3 to 100. The candidate has provided trainings on a diverse range of topics and has delivered trainings live, face to face, via webinar and via asynchronous recorded technology. As an adjunct faculty member, the candidate has also taught numerous courses such as Law and Ethics in Public Policy, Research Regulation Law and Research Litigation.
In addition to having his JD this candidate also has a Master’s Degree and is a Certified IRB Manager (CIM) and a Certified IRB Professional (CIP).
This candidate currently serves as Market Compliance and Privacy Officer with a system consisting of six hospitals, four large physician group practices and several ancillary facilities.
This candidate enjoys being responsible for the development, growth and maintenance of an organization’s compliance and privacy program and always aspires to build the strongest compliance and privacy program possible in an environment that supports the same mission.
This candidate works diligently to increase the visibility of compliance/privacy: Reporting of incidents has increased by more than 500% at each facility that the candidate has worked at. This candidate accomplishes this by using an old principle called MBWA (management by walking around) which allows the staff to get to know the candidate. This candidate uses these opportunities to educate subtly and to create positive relationships so that people know who to contact with questions and concerns and are not afraid to do so.
This candidate also sets high standards for the organization so that risks are mitigated to the greatest degree possible. This candidate prefers to grow the compliance program using CIA guidance. As CIA guidance changes, this candidate implements those elements that make sense and are applicable to the organization that the candidate works for.
In the audit programs that this candidate has developed, they audit across the spectrum, not just seeking overpayments but any mis-billings, to include those that were missed opportunities. This candidate also advocates the use of data mining to audit efficiently and effectively.
This candidate has an MBA and a Bachelor of Science Degree in Technical Management. This candidate is certified in Healthcare Compliance.
This candidate has a broad depth and breadth of healthcare compliance knowledge and experience including program implementation, upgrading policy, processes and communications, overseeing Code of Conduct and Conflict of Interest programs, privacy, fraud/waste/abuse and investigations as well as experience in the insurance “payer” space. This candidate has experience as a Compliance and Privacy Officer at a large and prominent hospital system and medical group and as Compliance Lead for a large academic hospital system and medical group. Responsibilities included implementing the compliance program, training, overseeing compliance research and reviewing applicable state and local government requirements.
This candidate reduced risks at the system’s teaching hospital through the implementation of a new research compliance initiative and saved costs for the health system through the release of internally developed, effective compliance education solutions.
This candidate has an MBA, and CPCO, CHC, CHP, CHRC and HCAFA certifications.
This candidate has 15 years of experience in compliance having served as Medical Auditor, Director of Revenue Integrity and Compliance Officer. This candidate is also an experienced RN with Compact States Licensure.
This candidate has solid knowledge of healthcare related laws and regulations including Stark, Anti-kickback, False Claims Act, HIPAA, EMTALA as well as OIG Work Plans and Federal Sentencing Guidelines. This candidate also has experience working under a Corporate Integrity Agreement.
This candidate is a strong leader having previously managed approximately 60 employees and maintained budgets across several hospital units and was responsible for system wide Joint Commission preparedness in a previous role. This candidate revised/revamped Compliance Programs and provides compliance training to all employees at the system. As Director of Revenue Integrity, this candidate helped in the implementation of changes in the hospital’s Chargemaster as well as identified inconsistencies in the ancillary system interfaces that resulted in a large net revenue increase. Additionally, this candidate has experience as Privacy Officer.
This candidate has a Master of Science in Nursing, is a Certified Fraud Examiner, Certified Professional Coder and is Certified in Healthcare Compliance.
This candidate is well-seasoned with a great depth and breadth of experience in compliance, audit, finance and operations. The candidate has large healthcare system experience coming from a 5 hospital system with approximately 2,000 beds where the candidate was responsible for the Internal Audit and Compliance functions for multiple hospitals within the system as well as the Physician Organization and a Research Enterprise. The candidate managed a large staff including two directors, a manager and a research auditor and was responsible for the dotted line supervision of locational compliance & privacy officers and chaired the System Executive Compliance Council.
This candidate has a proactive service approach to compliance and audit and has the ability to obtain the support of senior management in the implementation of the compliance program which has resulted in improved efficiency, reduced costs and potential liabilities are avoided. With this candidate’s active listening skills and practical approach the candidate is also able to obtain the support from physician leadership and the General Counsel.
In addition to being a CPA, this candidate also has an MBA with an emphasis in Accounting and Finance and a BA in Business Economics.
This candidate is an experienced compliance professional (healthcare and data protection) and attorney with several years of leadership experience in both evaluating and implementing programs which identify deficiencies, fraud, abuse, waste and integrate efficiencies within organized operations. This candidate has experience working as a government Regulator, as well as a Chief Compliance, Information Security, and Privacy Officer, and as SME/Consultant for non-profit and for profit entities.
This candidate has a proven track record of delivering cost-effective, timely healthcare compliance program evaluation, remediation, and management (Fraud Abuse, Anti-Kickback, False Claims, Red Flags), HIPAA (Privacy/ Security), Privacy Act, privacy and security compliance remediation services, and Meaningful Use Assessments, for Covered Entities such as large health systems, managed care organizations, hospitals, physician practice groups, accreditation organizations, data management organizations and research organizations.
This candidate has done consulting work and has served as a Subject Matter Expert to various clients. The candidate is well versed in the False Claims Act, Stark Laws, Red Flags, Privacy Act, HIPAA Privacy and Security, FISMA Compliance, the Freedom of Information ACT (FOIA) requirements, as well as the Affordable Care Act’s Meaningful Use Requirements. This candidate also has experience performing the tasks necessary to and to successfully complete Data Use Agreements (DUA’s), and Privacy Impact Assessments (PIA).
In addition to having a JD, this candidate also has a Master’s Degree in Health Policy Management and a Bachelor of Science Degree in Business Administration and Finance.
This candidate’s legal career has been spent solely in a healthcare environment and the candidate has litigated complex medical malpractice matters for over a decade. More recently, this candidate has become more engaged on an operational level at the hospital level; working with physicians, employees, patients and families.
This candidate served in a dual role as General Counsel and Corporate Compliance Officer for a 500 bed for profit community hospital system and led the company through two hospital acquisitions and a recapitalization, managing all due diligence, compliance and regulatory matters. This candidate is exceptionally skilled in negotiation and contracting, regulatory and compliance and as a corporate advisor. This candidate has developed and implemented a corporate compliance program where none existed. This candidate ensured all hospitals in the system achieved accreditation and regained CMS deemed-status twice. This candidate monitored a HIPAA regulatory process and despite an instance of an accidental breach of over 500 names, avoided the mandatory fine because of the timely and efficient manner in which the breach was handled.
In addition to having a Juris Doctorate, this candidate also has a Bachelor of Science Degree in Biochemistry and Physiology.
This candidate has 17+ years of progressive growth in healthcare compliance, privacy, security and internal audit. This candidate enjoys both assessing existing compliance programs and starting programs from scratch with the goal to always bring that health care system’s compliance program to be the best in the industry.
This candidate feels the success of compliance relies on the four C’s of compliance: 1) Communication, 2) Collaboration, 3) Culture and 4) Credibility. The candidate has 15 years of compliance, audit, privacy and security experience and currently reports to the organizations Board of Trustees with a dotted line reporting structure to the President and CEO. The candidate has worked in large health care systems and, most recently as a stand-a-lone Chief Compliance Officer.
The candidate has developed and implemented a comprehensive Conflict of Interest Policy survey process. After automating the survey and making some key revisions it had two years of 100% completion. This has not only saved time, but has resulted in employees and physicians asking conflict of interest questions prior to making certain decisions.
The candidate led an investigation that resulted in the hospital system settling with a vendor for $9 million. The candidate has excellent oral and written communication skills.
This candidate has CHC, CCEP and CHPC certifications and a Bachelor of Science Degree in Business Administration.
This candidate has 30+ years of diverse, high level administrative and management experience. The candidate has extensive experience in research contracting in the areas of academic, state, federal, human subject, basic science, private consulting and pharmaceutical research, program administration, management of large and innovative new initiatives, research compliance, research administration and management, technology transfer development and liaison responsibilities with federal and state agencies, university administration and faculty, private consulting firms and pharmaceutical companies. This candidate is a recognized leader in developing new programs, conducting peer reviews, regulatory compliance, managing budgets and resource allocation. The candidate has the proven ability to manage staff and is recognized as a mentor for staff development.
This candidate is experienced in managing and initiating research compliance activities, including the consideration of risks as well as impacts and implications and is experienced in the areas of academic, basic science and animal laboratories. The candidate is an experienced trainer and has developed, established and provided training materials, programs and other tools for Research Investigators, Study Coordinators, Research Administrators and all laboratory staff to improve safety and the quality of research results and data. This candidate has reviewed, revised and developed Institutional Policies to maintain adherence to laws, regulatory guidelines and best practices.
This candidate holds a Master of Public Administration and a Bachelor of Arts Degree in Government and Politics.
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