Chief Compliance Officer (CCO)

The Chief Compliance Officer (CCO) is primarily responsible for overseeing and managing compliance within an organization, ensuring that the company and its employees are complying:

  1. With regulatory requirements
  2. With internal policies and procedures

The Chief Compliance Officer (CCO) is the architect & steward of enterprise compliance strategy, structure and processes.

As the compliance leader and subject matter expert, the Chief Compliance Officer is responsible for establishing standards and implementing procedures to ensure that the compliance programs throughout the organization are effective and efficient in identifying, preventing, detecting and correcting noncompliance with applicable rules and regulations.

The Chief Compliance Officer has to provide reasonable assurance to Senior Management and the Board of Directors that there are effective and efficient policies and procedures in place, well understood and respected by all employees, and that the company is complying with all regulatory requirements.

The Chief Compliance Officer must report directly to the Chief Executive Officer. He must also inform the Board of Directors about important issues and material violations.

Chief Compliance officer's duties include:

  • Maintaining current knowledge of laws and regulations, keeping abreast of recent changes
  • Developing the annual compliance work plan that reflects the institution's highest risks that will be monitored by the compliance function as determined by conducting a mandatory annual risk assessment using an enterprise wide approach.
  • Providing guidance to the board of directors, senior management, staff, and employees on compliance
  • Overseeing and monitoring the implementation of the compliance program
  • Developing policies and programs that encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.
  • Reporting on a regular basis on the progress of implementation, and assisting these components in establishing methods to improve efficiency and quality of services, and to reduce the vulnerability to fraud, abuse, and waste
  • Periodically revising the program in light of changes in the needs of the organization, and in the law and policies and procedures of government and private payer health plans
  • Developing, coordinating, and participating in a multifaceted educational and training program that focuses on the elements of the compliance program, and seeks to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent federal and state standards
  • Developing materials at an institutional level for distribution to all employees to enhance awareness of compliance activities, including posters
  • Coordinating internal compliance review and monitoring activities,
    including periodic reviews of departments
  • Responding to government investigations and queries as the principal
    oint of contact
  • Independently investigating and acting on matters related to compliance, including the flexibility to design and coordinate internal investigations (e.g., responding to reports of problems, 'hot-line' calls, or suspected violations) and any resulting corrective actions with all health system departments, providers and sub-providers, agents and, if appropriate, independent contractors
  • Monitoring external audit review processes, maintains awareness of compliance issues, and in conjunction with the Office of General Counsel and senior management, responds to administrative inquiries related to compliance issues or audits.

You can read about:

The Challenges for the Chief Compliance Officer

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