Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.
Oversees compliance across an integrated delivery system, including both health plan and care delivery operations. Designs, implements, and manages a comprehensive Enterprise-Wide Compliance & Privacy Program aligned with federal guidance from the OIG, OCR, and industry standards. Partners with senior leadership to identify and mitigate enterprise risks, ensure regulatory readiness, and uphold ethical conduct through robust policies and the PHS Code of Conduct. Continuously evaluates program effectiveness to prevent, detect, and correct legal or policy violations.
This position is intended to be conducted in the state of New Mexico, with in-office presence. Relocation assistance is available.
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Ensures that PHS has established a written Code of Conduct and compliance standards, policies and procedures covering all necessary areas to be followed by PHS employees and other workforce members and contractors.
Ensures that PHS standards and procedures are updated as needed and are effectively communicated to appropriate employees, other workforce members and contractors through training programs, newsletters, memoranda, and other means.
Ensure that monitoring and auditing procedures to determine compliance with PHS standards, policies and procedures have been established and implemented.
Develops and implements the PHS compliance risk assessment and audit plan and conducts regular audits and monitoring to identify and mitigate compliance vulnerabilities.
Ensure that investigations of alleged violations of regulatory requirements, PHS standards, policies and procedures are promptly handled by the appropriate individuals.
Ensure that PHS compliance policies are consistently enforced by appropriate disciplinary measures and works closely with PHS leadership to reinforce a culture of compliance.
Works with leadership and operational areas to ensure that PHS addresses audit findings as required.
Ensure that PHS takes appropriate action to mitigate potential risks, to respond appropriately to misconduct if it occurs, and to prevent a recurrence of any such misconduct.
Makes periodic reports regarding the Compliance Program and compliance issues directly to the CEO.
Oversees the implementation of processes, including the PHS Hotline, for workforce, patients, members, and the public to seek guidance on compliance and business conduct issues and to report confidentially on suspected violations of the law or PHS policies and procedures.
Provides guidance regarding PHS compliance standards, policies, and procedures.
Assures that the effectiveness of the PHS Enterprise Wide Compliance Program is regularly assessed and opportunities for improvement identified and addressed.
Facilitates the Ethical Business Practices Committee and works with senior leaders and others to prevent, detect and resolve compliance issues.
Serves at the lead PHS staff for the PHS/PHP Compliance & Audit Committee and works with the Board Committee Chair on agenda, reporting, and Committee member contact.
Facilitates the PHS Conflict of Interest Committee and reporting process for employees and Board members and works with Committee members to review and address all reported disclosures.
Works with Medical Staff Affairs to coordinate the annual Financial Disclosure reporting process and addresses all disclosures, including those identified on the CMS Open Payments database, in collaboration with physician leadership.
Works with operational leaders on controls to safeguard PHS data including but not limited to data access, interfaces, transfers, sharing data with vendors and artificial intelligence.
Develops and manages the annual Compliance department operating budget.
Creates a strong working relationship with the Chair of the PHS Board of Directors and its members as well as the Chair of the Compliance & Audit Committee.
Stay current with new or revised federal legislation, regulations, and industry best practices.
Reviews, as appropriate, materials and business operations for compliance with government requirements.
Gathers and analyzes information and data from internal and external sources as necessary to enhance enterprise compliance with regulatory requirements. Sets precedent. Research issues using a variety of resources.
Works with legal and other subject matter experts to interpret government regulations and internal policies.
Identifies and develops recommendations for business operations improvement.
Develops and conducts educational presentations and training on the Compliance Program and regulatory requirements. Serves as a Compliance resource for the enterprise.
Serves as the Enterprise point of contact, as appropriate, for regulatory agencies and auditors.
Works with legal and other subject matter experts to interpret government regulations and internal policies.
Identifies and develops recommendations for business operations improvement.
Develops and conducts educational presentations and training on the Compliance Program and regulatory requirements. Serves as a Compliance resource for the enterprise.
Serves as the Enterprise point of contact, as appropriate, for regulatory agencies and auditors.
We offer more than the standard benefits!
Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!
Learn more about our employee benefits:
https://www.phs.org/careers/why-work-with-us/benefits
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.
Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.
About New Mexico
New Mexico continues to grow steadily in population and features a low cost-of living. Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.
New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.