Corporate Compliance Consultant 2

Job Summary

Baylor Scott & White Health (BSWH) is committed to the operation of an effective compliance program. Corporate Compliance Consultant 2 is an intermediate-level compliance professional responsible for conducting defined compliance audits, investigations, monitoring activities, regulatory reviews, and corrective action follow-up under general direction. This position applies working knowledge of healthcare compliance requirements to evaluate risk, develop practical recommendations, provide education and consultation, and support effective compliance program operations across assigned hospital, medical group, provider, billing, coding, research, and third-party compliance risk areas.

Essential Functions of the Role

Audit and Monitoring Support

• Conduct compliance audits, monitoring reviews, and assigned investigative activities involving defined regulatory areas.

• Apply established audit methodologies and testing procedures to assess compliance with organizational policies and regulatory requirements.

• Document findings, identify potential compliance risks, and recommend practical corrective actions.

• Escalate complex or high-risk issues to senior compliance consultants or leadership.

Regulatory Knowledge

• Research and apply healthcare compliance regulations, billing and coding requirements, reimbursement guidance, and organizational policies.

• Help interpret guidance from the Centers for Medicare & Medicaid Services (CMS), Office of Inspector General (OIG), Department of Justice (DOJ), Food and Drug Administration (FDA), Office for Human Research Protections (OHRP), National Institutes of Health (NIH), Office of

• Research Integrity (ORI), state agencies, and accrediting organizations, as relevant to the role.

• Communicate relevant regulatory information and compliance expectations to assigned operational areas.

Investigations

• Assist with investigations involving alleged compliance concerns.

• Gather and analyze documentation, interview information, and other relevant evidence as assigned.

• Support root cause analysis and assist in developing corrective action recommendations.

• Prepare draft summaries and reports for review by senior compliance team members.

Program Support and Consultation

• Support the development and maintenance of compliance monitoring plans, audit tools, risk assessments, reporting resources, and issue-tracking processes.

• Develop and maintain assigned compliance education and training materials; coordinate and monitor timely lesson completion as appropriate.

• Track assigned corrective action plans, perform follow-up monitoring, and escalate delays or unresolved risks.

• Provide compliance consultation and present education, findings, recommendations, and corrective action status to assigned operational stakeholders and compliance team members.

• Participate in enterprise compliance initiatives, workgroups, and cross-functional projects as requested.

Key Success Factors:

• Working knowledge of healthcare compliance program requirements, billing, coding, documentation, reimbursement, provider, research, and third-party compliance risk areas relevant to assigned responsibilities.

• Knowledge of auditing, monitoring, investigation, documentation, and corrective action methodologies.

• Strong analytical, documentation, follow-up, and problem-solving skills.

• Effective written, verbal, educational, and presentation skills appropriate for operational and compliance audiences.

• Demonstrates sound judgment, discretion, objectivity, confidentiality, integrity, and ethical conduct; consistently models the BSWH Code of

• Conduct and the professional standards and expectations of the BSW Corporate Ethics & Compliance team.

• Ability to manage assigned projects and competing deadlines with general direction and to escalate complex or high-risk matters appropriately.

• Ability to collaborate effectively with operational leaders, cross-functional stakeholders, and compliance team members.

Preferred Qualifications

Education: Bachelor's degree in Legal Studies, Nursing, Health Administration, Business, Healthcare Administration, Coding, Compliance, Public Health, or related field required. Advanced degree or applicable healthcare certification preferred.

Experience : 2+ years of healthcare compliance, audit, coding, billing, regulatory, legal, healthcare operations, revenue cycle, clinical documentation, research, or related experience, including experience conducting audits, monitoring reviews, investigations, or corrective action follow-up.

Certifications: At least one of the following:CHC, CHPC, CHRC, CPC, CCS, RHIA, RHIT, RN, JD, or other applicable healthcare compliance, coding, legal, clinical, audit, or regulatory certification preferred or obtained within an approved timeframe based on business need.

Minimum Qualifications

Education: Bachelor's or 4 years of work experience above the minimum qualification

Experience: 3 Years of professional experience

As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.