The AVP, Investigations assists in the operation and management of the Company Investigations program and is responsible for assuring the quality of the internal investigation program to include an effective and consistent approach to reporting/intake, triage, investigation, corrective action recommendations and documentation of each step in the investigation process. The AVP will investigate, and support investigations undertaken by members of the Head of Internal Investigations, Business Integrity Partner team, the Compliance Monitoring and Regulatory Support team and market- or facility-level Ethics and Compliance Officers. The AVP will work closely with and support investigations by other functions, including Legal, Human Resources, Risk, Privacy and Security. The AVP will align their efforts to prevent, detect, and correct non-compliance and will support an environment that encourages information sharing, collaboration, and process improvement to ensure effectiveness, efficiency, and service excellence across multiple teams.
About LifePoint Health:
LifePoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities.We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
- To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.
- Responsible for continuously improving internal investigations protocol and coordinating with other functions that conduct investigations, including Human Resources, Legal, Risk, Privacy and Security.
- Investigate, analyze, and apply judgment to complex fact patterns, including those requiring an understanding of federal health care program requirements, fraud and abuse laws and enforcement policies.
- Supervise, support and assure the quality, thoroughness and timely completion of investigations led by members of the Investigations team, Business Integrity Partner team, the Compliance Monitoring and Regulatory Team, market- and facility-level Ethics and Compliance Officers.
- Participate in and the lead the development of corrective action recommendations where compliance failures are identified.
- Responsible for implementing a framework to ensure consistent corrective action recommendations across the enterprise.
- Ensure all investigations, investigatory findings and recommendations for corrective action are appropriately documented.
- Produce and analyze reports of investigations to identify and highlight trends or systematic concerns.
- Participate in or otherwise support internal investigations conducted by other functional areas, including Human Resources, Legal, Risk, Privacy and Security.
- Regular and reliable attendance.
- Perform other duties as assigned.
- Access to and/or works with sensitive and/or confidential information.
- Exhibit a comprehensive understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.
- Responsible for supervising investigation team employee(s).
- Ability to lead effective team initiatives around key objectives; motivates team members to achieve objectives; provides clear direction and support to team members. Works well in a team.
Knowledge, Skills and Abilities:
- The requirements listed below are representative of the knowledge, skills and/or abilities required.
- Moderate Computer Skills -- Frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc. Ability to create, maintain and incorporate simple functions into documents, spreadsheets, databases, and presentations to support business objectives.
- Complex Communication: Frequently communicates complex information and interacts with management. Can present, resolve and address delicate situations. Can motivate and persuade others.
- Varied Business Problems: Problems are varied and complex, requiring analysis or interpretation of the situation. Problems are solved using knowledge and skills, general precedents and practices.
- Department Specific Impact: Decisions impact the management and operations within a department. May contribute to business and operational decisions that affect the department.
- Moderate Independent Judgement: Results are defined; sets personal own goals and determines how to achieve results with few or no guidelines to follow; supervisor/manager provides broad guidance and overall direction.
- Project Management: Handle multiple complex projects simultaneously including task delegation, project oversight, and resource allocation.
- Oversees and assures quality for a significant segment of a functional area within the department.