Chief Ethics Officer

Company: MaxHealth, LLC (MaxHealth)Title: Chief Compliance Ethics & Privacy Officer (CCEPO)Location: FloridaReporting Lines: The Chief Executive Officer (CEO) and the Board of Directors (the Board)ABOUT MAXHEALTHMaxHealth is dedicated to simplifying healthcare and ensuring healthier futures. Founded in 2015, MaxHealth is a leading primary care platform focused on providing high-quality, integrated care to adults and senior patients throughout Florida. We provide care for more than 110,000 lives, most of which are beneficiaries of government-sponsored healthcare programs like Medicare, or of health plans purchased on the Affordable Care Act exchange marketplace.We are customer-centered; compassionate; results-driven; proactive; collaborative; and adaptable in executing our vision to help patients live their best lives. Our mission is to deliver quality care, a simplified experience, and happiness. One patient at a time.THE ROLEAs a member of MaxHealth's senior management team, the CCEPO serves a critical role in enabling our success. They are responsible for the ongoing development and periodic assessment of MaxHealth's Compliance & Ethics (C&E) Program and management of the Privacy Program. The C&E and Privacy Programs must fulfill the expectations of key stakeholders, including patients, their families, regulators and enforcement agencies.The CCEPO is expected to promote an appropriate "Tone at the Top" that is consistent with MaxHealth's culture and core values. This is a senior leadership role that requires seasoned, pragmatic, and risk-informed judgment, and productive collaboration across MaxHealth and the greater healthcare ecosphere.ESSENTIAL DUTIES & RESPONSIBILITIESThe following description provides an overview of primary responsibilities for this executive position; it should not be interpreted as all-encompassing.General ResponsibilitiesEnsures that the Board, the CEO, and the Executive Leadership Team (the ELT) are timely informed of all significant compliance and privacy developments, including those involving internal and external allegations and reports of compliance and ethics concerns; privacy breaches; regulatory and enforcement inquiries; and key findings of internal compliance and privacy tests and assessments, audits, and monitoring initiatives.Works closely with the Board to facilitate fulfillment of the Board's oversight responsibilities.Undertakes to remain informed of the latest developments and trends in healthcare compliance, ethics, and privacy by, among other things, attending seminars, reviewing professional journals, and actively participating in professional organizations. Leverages that insight and knowledge to strengthen the effectiveness of the C&E Program and Privacy Program initiatives.Compliance ResponsibilitiesLeads the ongoing development of the C&E Program; responsible for ensuring that it is properly structured and has sufficient resources with the requisite expertise and experience.Chairs MaxHealth's Executive Compliance and Ethics Committee (ECEC) and is responsible for ensuring that it fulfills the mission and duties set forth in its charter.Ensures that the C&E Program develops and maintains the key controls, elements, and functions set forth in applicable regulatory and enforcement agency guidance, including the standards enunciated by the U.S. Department of Justice (DOJ), Office of Inspector General, U.S. Department of Health and Human Services (OIG), Centers for Medicare & Medicaid Services (CMS), and the Florida Agency for Health Care Administration (AHCA).Ensures that all employees and vendors are educated and trained on their compliance and ethics obligations.Responsible for the development and effective operation of a Disclosure Program that includes an anonymous hotline for receiving compliance and ethics concerns, a Disclosure Log, and protocols for assessing and investigating all reports of compliance and ethics concerns, whether received anonymously via a hotline or disclosed through an open-door channel.Serves as a Source of Truth to the Board and the ELT while maintaining a collaborative relationship with the CEO, the Chief Operating Officer, in-house and/or outside counsel, and the Senior Vice Presidents of Clinic Operations, as well as physician practice leaders.Prepares and presents periodic reports to the Board, the CEO, and the ELT.In collaboration with in-house and/or outside counsel, leads the annual review of compliance and ethics policies and procedures including the Code of Conduct and, as warranted, develops proposed revisions.Directly, or through a designee, leads the performance of an annual assessment of compliance risks and the development and implementation of an Annual Compliance Work Plan (Annual Work Plan). Reviews the Annual Work Plan with the ECEC, the Board, the CEO, and the ELT and provides those internal stakeholders with periodic updates as it is executed.Ensures the implementation of effective correction action plans in response to identified compliance and ethics issues.Periodically directs an assessment of the Program's design, staffing, and operational effectiveness and reports the observations and findings to the Board, the CEO, and the ELT.Privacy ResponsibilitiesLeads the development of the Privacy Program; responsible for ensuring that it is properly structured and has sufficient resources with the requisite expertise and experience.Promotes Health Insurance Portability and Accountability Act (HIPAA) awareness amongst the Board, CEO, ELT, vendors, volunteers, and all Company employees both in personal conduct and leadership over privacy initiatives such as policies and procedures and training.Ensures that the Privacy Program develops and maintains the key controls, elements, and functions set forth in applicable regulatory and enforcement agency guidance, including the standards enunciated by the U.S. Department of Health and Human Services.Collaborates effectively with in-house and/or outside counsel and the Chief Information Officer (CIO), as well as Information Technology personnel.Identifies areas of privacy vulnerabilities and risk areas and develops both preventive and corrective action plans and provides general guidance for how to avoid or handle similar situations in the future.Performs or oversees required routine incident and breach assessments, documentation, and mitigation, and reports observations and findings to the Board, the CEO, and the ELT.EXPERIENCE & EDUCATION Five to ten years of relevant professional experience in healthcare. Experience in medical practice management and/or a relevant federal or state agency is preferred.An undergraduate degree, preferably in law, business management, or a related field; preference for a Juris Doctor degree from an accredited law school, with a strong academic record and admission to a state bar. Clinical experience will also be considered.Preference for high-caliber healthcare compliance certification, such as Certified in Healthcare Compliance (CHC) Certificate from the Health Care Compliance Association (HCCA), along with a fundamental understanding of regulatory frameworks and coding practices.Preference for privacy certification such as Certified in Healthcare Privacy Compliance (CHPC) from HCCA or Certified in Healthcare Privacy and Security (CHPS) from the American Health Information Management Association (AHIMA); other AHIMA certifications (e.g., Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)) will also be considered.Highly preferred, Florida Law KnowledgeRobust working knowledge of managed government healthcare program (i.e., Medicare and Medicaid) requirements and applicable laws and regulations, including those concerning healthcare fraud, waste, and abuse.Demonstrated ability to work effectively with key internal and external stakeholders. Prior experience working with management committees, boards, and governing bodies is preferred.PROFESSIONAL PROFILEKey Leadership and Management Skills A strategic mindset with a focus on creating value by exceeding stakeholder expectations.A demonstrated ability to cultivate highly productive working relationships with senior leaders, peers, and government agencies.An ability to analyze complex information with strong attention to detail.An ability to operate successfully in a flat culture, with the courage and competence to engage on multiple fronts and tackle challenges head-on.An ability to build and inspire a team while effectuating organizational change.An ability to prioritize effectively, and exercise sound judgment, in a fast-paced, physician-driven environment.An ability to communicate effectively both verbally and orally.A demonstrated ability to leverage technology to improve mission-critical processes.A successful track record of advocating for a position while remaining receptive to the views of others, with the intellectual flexibility to craft alternate paths and solutions.Personal CharacteristicsExemplary integrity with courage and an unwavering ethical compass.Seasoned and pragmatic, risk-aware professional judgment.An ability to analyze complex matters and situations three-dimensionally, while distilling relevant information and identifying viable paths forward.An executive presence with the knowledge and stature to convey advice in a manner that is valued and respected by senior leadership and external stakeholders.Demonstrated tact, trustworthiness, and diplomacy skills needed to manage sensitive and confidential information such as protected health information (PHI).An adept listener with a sense of humility.An approachable, empathetic professional with capability to understand different values across a wide range of perspectives.Ability to travel locally, as needed.Ability to stand, sit, bend, reach overhead, and carry 25 pounds, if necessary.

Created: 2025-03-07