Lori Dutcher Email & Phone Number

Duarte, Ca, Us

Responsible for all aspects of the corporate compliance program for all corporate entities including; City of Hope National Medical Center, the Beckman Research Institute of the City of Hope and the City of Hope Medical Foundation and TGen (Translational Genomics Research Institute).Oversee the organizations Internal Audit program and risk assessment processes and provides direct oversight to the executive director of internal audit.Program oversight for Privacy and Security, Revenue Cycle, Research operations and Conflict of Interest as well as Compliance program operations.Report on compliance program activities to executive compliance committee and audit and compliance committee of the board of directors.Provide advice and counsel to senior leadership on evaluating risk and mitigation strategies, including leadership of the Enterprise Risk Management Program.

Canton, Massachusetts, Us

Responsible for the leadership of the compliance program for a multi-state health insurance company. Medicare compliance program oversight. Reporting to the audit committee of the board of directors on compliance matters.

Canton, Massachusetts, Us

 Hold oversight and direction of compliance for all product lines in country’s top-ranked health plan (#1 in 2014-2015 NCQA Plan Rankings in both Private Health Insurance Plan and Medicaid Health Insurance Plan).  Direct development and refinement of complex compliance and ethics programs that ensure entire organization meets both federal and state requirements.  Lead implementation of program structure required to ensure compliance with federal Medicare requirements.  Administer organizational compliance program for human resources including OFCCP compliance. Provide regular independent and objective reports to Board of Directors on organization’s compliance program, working closely with Chair of Audit and Compliance Committee.

Oakland, California, Us

 Lead compliance organization for multi-hospital region with integrated delivery system including medical offices, pharmacy operations, skilled nursing and home care operations across 21 medical centers; 160 medical offices; 3.2 million members. Hired, trained, and managed cross-functional compliance and privacy staff.  Led change that transformed compliance program to strategic partner, to support organization’s patient-focused mission by combining innovation and integrity.  Named to national team developing integrated risk management program across enterprise’s risk organization (e.g., internal audit, IT Privacy and Security, SOX, Regional and Functional compliance units).  Develop and mentor next generation of compliance leaders for regional and MSSA compliance.

Oakland, California, Us

Vice President (VP), Compliance – Health Plan Marketing, Sales & Business Development, Health Plan Administration  Promoted to member of national health plan executive team, overseeing corporate compliance staff and regional compliance officers and teams supporting 3.3 million members. Developed and implemented strategy for compliance across multiple business functions and business lines, including Medicare, commercial HMO, and other fully-insured and self-funded health plans in conjunction with Medical Groups and Kaiser Foundation Hospitals (together, Kaiser Permanente) in nine states and District of Columbia.  Headed development and implementation of company-wide compliance infrastructure across all product lines, including sales and marketing, actuarial, pricing and underwriting, claims, membership administration, member services call centers, benefits administration, and new product development.  Directed coordination and efficiency of internal auditing, including privacy and security matters and internal investigations. Oversaw development of training and education to address issues. Led implementation of monitoring scorecards integrated with business scorecards. Defined disaster recovery planning for all health plan functions.  Presented to Board of Directors Audit and Compliance Committee.

Oakland, California, Us

 Hired, trained, and managed cross-functional staff of 25 handling compliance and privacy for 11 hospitals and 3.3 million members. Headed development, implementation and ongoing refinement of Southern California regional strategy for effective compliance program, including Medicare, state, federal, HIPAA, insurance and clinical compliance.  Member of Southern California executive team.

Oakland, California, Us

 Directed all aspects of regional compliance for fully-insured and self-funded health plans in Maryland, Virginia, and District of Columbia.  Managed development and implementation of Mid-Atlantic States regional strategy to improve compliance program, including Medicare, state, federal, HIPAA, insurance and clinical compliance.  Chaired Regional Compliance Committee.  Played active role in review and approval of corrective action plans for business units.

Seattle, Wa, Us

 Handled legal and regulatory affairs for this former $1 billion Kaiser Permanente division in New York, Massachusetts, Vermont and Connecticut.  Oversaw clinical risk management, benefit and contract administration, government regulation and regulatory compliance functions. Member of Senior Management Team.  Provided both day-to-day and strategic legal advice on diverse issues including ERISA, labor and employment, benefit coverage, patient care, medical staff, and general business matters.

Leading With Ethics And Compliance

Executive Education, Kaiser Permanente Advanced Leadership Program

Juris Doctor (J.D.), Law

Bachelor Of Applied Science (B.A.Sc.), Business Administration And Management, General