Chief Compliance Officer & Hipaa Privacy Officer
Denver, Colorado, Us
As a senior executive leader, I directed and scaled the corporate compliance function for the Providence Service Corporation and subsidiary LogistiCare, (now ModivCare, NASDAQ: MODV), a $2.5B medical transportation and in-home healthcare provider with 20K employees and 10K subcontracted providers. Some of my accomplishments include:- Steering and evolving a multi-level compliance Center of Excellence with 80+ national employees in Corporate Compliance, Medicaid and Medicare FWA/Program Integrity, Privacy, Safety, Risk Management, and Provider Credentialing departments- Acting as go-to subject matter expert in Medicare Advantage and Medicaid Managed Care contracting and regulatory compliance, Affordable Care Act (ACA), False Claims Act, Stark Law, and Anti-Kickback Statute matters- Aligning all workforce and subcontractor compliance activities with DOJ and OIG elements of effective compliance programs by updating and implementing codes of conduct, compliance policies and procedures, conflict of interest disclosures, and training and education materials- Successfully obtaining substantial monetary recoveries by establishing a highly efficient 20+ member Special Investigations Unit to detect, investigate, mitigate, and prevent healthcare FWA- Serving as HIPAA Privacy Officer responsible for developing HIPAA policies and procedures, drafting and negotiating business associate agreements (BAAs), training workforce and subcontractors on HIPAA privacy and security, and remediating security incidents and potential HIPAA breaches- Successfully facilitating HIPAA, SOC, URAC, and HITRUST audits, recertifications, and effectiveness reviews- Ensuring full regulatory compliance with HIPAA, COPPA, CCPA, TCPA, and state privacy and information security laws, including drafting and updating policies and procedures in close collaboration with CISO