Senior Vice President of Audit

General Purpose Reporting to the Chief Compliance Officer ("CCO"), this position supervises and manages compliance audits to determine organizational integrity of billing for services. This position will also support the CCO with transactional audit diligence and integration planning, as well as the development and completion of the annual enterprise risk assessment and audit and monitoring plan.  The SVP of Audit has supervisory responsibility for all Compliance Audit staff. Essential Duties Plans professional compliance department audits to determine accuracy and adequacy of documentation and coding related to all claims associated with clinical services and medical necessity reviews. Prepares written reports of audit findings and recommendations; presents to appropriate stakeholders; evaluates the adequacy of management corrective action to improve deficiencies; maintains audit records. Conducts risk assessments to define audit priorities based on previous audit findings, management priorities, coding utilization patterns, national normative data, CMS initiatives, OIG work plans and advisories as well as healthcare industry best-practices. Develops and implements compliance training and education to ensure compliance with federal and state regulations and laws, CMS and other third-party payer billing rules and internal documentation, coding and billing policies and procedures. Provides feedback and training including but not limited to medical necessity requirements, documentation standards, billing and coding requirements. Serves as institutional subject matter expert and authoritative resource regarding federal, state and payer documentation, billing and coding rules and regulations, maintaining awareness of governmental regulations, protocols and third-party requirements. Develops and implements a three-year audit strategy to drive measurable performance improvement. Develops monthly and quarterly reports that track overall audit performance, measures effectiveness of performance improvement plans and reports on findings and associated recommendations to the Company's Executive Compliance Committee and the Chairman of the Audit Committee.  Responsible for establishing and managing the annual compliance audit budget oversight Conducts an annual risk assessment of the company's overall audit status. Responsible for oversight, growth and development of the audit team.  Will establish individual goals for each audit team member to promote professional growth and development Foster a relationship of trust and confidence between operations and compliance through transparency, positive influence, empowerment and accountability.  Serves as liaison with 3rd party auditors conducting audits as well as manages in-house auditing staff. Actively directs and supports the overall workplan of the Compliance Department. Qualifications Bachelor's degree in Health Information Management, Business or related field preferred. 6+ years of experience in long-term care compliance auditing, medical necessity reviews, or related work; operational knowledge a plus. AAPC, AHIMA or HCCA Coding certification and or Auditing/Compliance certification (CPC, CCS, CCS-P, COC, CPMA, CHC) preferred.   Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; recommends opportunities to strengthen the internal control structure. Understands institutional risks and shows appropriate judgment, using a risk-based approach in planning and executing audit plans. Expert-level knowledge and application of Medicare/Medicaid documentation and coding rules and guidelines; ICD/CPT/HCPCS/DRG/APC documentation coding rules; medical terminology; E/M rules; healthcare compliance audit methodology, principles and techniques; ability to interpret medical record progress notes, handwritten and electronic chart entries, provider orders and other related documentation during audit reviews. Ability to communicate complex and potentially sensitive issues to all levels of management, providers, and others; strong presentation and communication skills (MS Word, Excel, PowerPoint, and Outlook). What is expected of you and others at this level Manages audit program and supervises audit staff, collaborates with operations and other business support staff Applies advanced knowledge and understanding of concepts, principles, and technical capabilities to manage a wide variety of projects Participates in the development of policies and procedures to achieve specific goals Recommends new practices, processes, metrics, or models for a successful auditing program Possesses strong attention to detail Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment Independently determines method for completion of new projects Receives guidance on overall project objectives Excellent time management, personal integrity and ability to maintain confidentiality. Physical Demands Primarily sedentary role with extended periods of computer work Occasional standing, walking, and light lifting (up to 10–20 lbs) Regular use of hands for typing and office equipment Ability to read and review detailed documents Clear verbal and written communication required Occasional travel based on business needs Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually low to moderate. Join PACS: Elevate Healthcare with Us PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment , we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide. If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let's shape the future of healthcare Join Our Team and Thrive At PACS, we believe our employees are our greatest asset. That's why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle. Our Comprehensive Benefits Include Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy. PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge. Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively. Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings. Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges. Join us at PACS and take advantage of a workplace that truly values you We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.