Auditor, Compliance Sr

The Senior Compliance Auditor assists in effectively meeting company objectives by auditing hospitals and other Tenet entities per the current year’s Referral Source Compliance Work Plan, assisting and advising management regarding the effectiveness of company operations, internal controls and financial reporting matters involving referral source arrangements. The Senior Auditor will also assist management in building and enforcing an effective referral source compliance program by assessing risks, monitoring risk management activities, developing and executing audit plans based on risk assessment results and coordinating communication of audit results. The Senior Auditor reports to the Director, Referral Source Compliance Programs for Tenet Healthcare.

This position is responsible for coordinating the implementation, monitoring, and enforcement of compliance initiatives for the Tenet enterprise that promotes understanding of, and compliance with, Federal and State laws and regulations as well as Policies that pertain to Tenet’s interactions with actual or potential referral sources.

Duties & Areas of Responsibility

Assist with revamping the relocations and guarantee agreements reconciliation review process:

• Review of existing policies and, in coordination with the Law Department, assist with development and revision of Standard Operating Procedures and Job Aids as necessary.
• Assess relocation and guarantee reconciliation review work plans and areas of focus to ensure they are appropriately focused and tailored.
• Conduct relocation and guarantee reconciliation reviews and communicate results to the relevant stakeholders in accordance with the applicable contracts and Standard Operating Procedures set forth.

Execute Referral Source Audit Program

• Conduct Referral Source audits in the field and in the office, to accomplish audit objectives identified during risk analyses while demonstrating flexibility in responding to changes in assignments and job responsibilities.
• Prepare audit programs for review by managers and evaluating results and findings upon completion of audit.
• Make practical recommendations for process improvements while ensuring that recommendations reflect an understanding of the business, Tenet policies, Federal and State Anti-kickback, Stark and related laws.
• Communicate results of referral source audit projects to management and operations personnel directly involved with department projects, and as requested, to company senior management and the Audit Committee of the Board of Directors.
• Adhere to the department’s quality assurance process for planning, analysis, documentation and reporting on all referral source audit projects.
• Conducting referral source audit follow-up activities and monitor remediation efforts.

Assisting with periodic data analytics and risk analyses to facilitate identification of referral source audit projects; 

• Assist with aggregation and analysis of data produced from Compliance risk assessments, as well as other sources, to identify potential areas of risk.
• Assist in developing data analytics metrics to detect flags and trends for follow-up involving potential noncompliance in arrangements with referral sources.

Assist with other data analytics and report compilation as needed within the Compliance department.

Assist with development and delivery of appropriate training programs to promote understanding of relevant requirements to the referral source audit team and Tenet’s business operators.

Serve as a subject matter expert and consultant in the areas of relocation and guarantee agreements and reconciliations for internal constituents.

Qualifications:

• Candidates should be able to demonstrate an understanding of compliance program elements, and applicable laws (including, but not limited to the Stark law and the Anti-kickback Statute), regulations and industry leading practices involving referral source arrangements as well as relevant Tenet policies. 
• Candidates should also demonstrate strong problem structuring and solving skills, as well as be an effective communicator. 
• Candidates must have the ability to efficiently and effectively review services, leased space, medical supplies, medical devices, equipment, or other items or services provided to or received from Referral Sources to ensure that the use of such resources is compensated pursuant to a written Agreement that complies with Tenet policies, federal and state Anti-kickback, Stark and related laws. 
• Candidate should also have the ability to review referral source relocation and guarantee agreements and subsequent reconciliations for compliance with Tenet policies, federal and state Anti-kickback, Stark and related laws.