Summary:The Field Director Compliance Investigations is responsible for conducting critical investigations into allegations of fraud, waste, and abuse; violations of company policies; violations of federal and state health care laws and regulations; and other matters reported to the Company’s Compliance hotline, discovered in internal or external audits, or identified by Company leadership or employees. Thorough and prompt investigation of these matters requires the utmost in health care investigative experience and expertise, discretion, judgment, and integrity. Essential Duties:
Reporting directly to the Senior Director Compliance (SDC) and/or the Vice President of Compliance (VP-Compliance), the Field Director Compliance Investigations will:
Plan, lead, and conduct internal investigations. This includes but is not limited to assessing the allegations or underlying concerns; developing an investigative plan; identifying, obtaining, and reviewing relevant documents and evidence; conducting witness interviews and assessing witness credibility; and concluding investigations in a timely manner.
Prepare thorough and accurate written reports of interviews and investigations; document investigative findings; provide timely updates to the SDC and /or VP-Compliance; and coordinate with legal counsel in privileged investigations.
Identify areas of potential risk and liability exposure and provide suggestions or action plans to minimize the Company’s risk exposure and improve compliance with federal and state health care program requirements and Company policies.
Provide investigative assistance, guidance, and instruction to other Field Directors of Compliance, as well as operational and clinical personnel; providing investigative training to other company personnel.
This position will primarily be assigned to conduct investigations regarding the Kindred At Home Division (home health, hospice, and community/personal care), but the employee’s investigative experience and expertise may be utilized in other Kindred Divisions as well, at the discretion of the VP-Compliance and the Chief Compliance Officer.
Some of the role’s duties may be performed remotely, and thus the position can be based anywhere within the Continental U.S. However, certain job functions (such as interviews) require in-person presence and thus extensive domestic travel will be required.
Bachelor’s degree or higher.
Minimum 10 years of investigative experience.
Experience leading and conducting complex and/or highly-sensitive investigations (preferably in the health care industry).
Prior work experience as a special agent or federal or state law enforcement officer with HHS-OIG, FBI, other Federal OIG or agency, or MFCU; alternatively, Certified Fraud Examiner (CFE) or similar designation.
Ability to work well independently and as part of a team.
Attention to detail.
Must be computer literate and have competency in MS Word, Excel, and Outlook.
Due to the nature of this Compliance position, the successful applicant must have the highest degree of ethics and integrity.Strongly Preferred Qualifications:
Knowledge of federal and/or state health care laws, rules, and regulations, including the False Claims Act and the Anti-Kickback Statute; familiarity with CIAs is also desirable.
Experience investigating or working in the hospice, home health, and/or home care/personal care assistance fields.
Experience conducting health care audits is helpful, but not required.