The Vital Role of Compliance Officers in Healthcare Organizations

Amber Ratcliffe
woman outside hospital

As healthcare organizations navigate an ever-changing regulatory landscape, compliance with laws, regulations, and policies has become more important than ever. Compliance officers are critical in ensuring that healthcare organizations meet these requirements. But while it might seem obvious, not every organization truly understands the role of a compliance officer — both the scope of their oversight and the duties they’re responsible for.

Let’s discuss the role of the compliance officer in a healthcare organization: what they do, how to find the right person for this role, and the characteristics and skills needed to be successful in this position.

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What Is a Healthcare Compliance Officer?

A Healthcare (Hospital) Compliance Officer (HCO) is a professional who ensures that their organization adheres to all applicable laws, regulations, and policies. They are responsible for developing, implementing, and monitoring compliance programs that help the organization stay within legal and ethical boundaries.

While it’s easy to think of an HCO as a glorified hall monitor — and far too many organizations do — the reality is, an HCO is an extremely valuable resource in achieving high-level healthcare goals. Better patient care, improved workplace safety, lower organizational costs, better accountability — all of these and more stem from the work a healthcare compliance officer does to create compliance across the board.

In simplest terms, an HCO leads the charge in ensuring things are done the right way, the first time, every time. And, when they’re not or issues creep into the picture, they’re the individual responsible for identifying them, remediating them, and keeping the organization on track for excellence.

What Does a Compliance Officer Do?

Compliance officers in healthcare organizations have a wide range of responsibilities. Some of their primary duties include:

  • Developing and implementing compliance programs: Compliance officers create programs that ensure their organization complies with all relevant laws and regulations.
  • Monitoring compliance: They also monitor the organization’s adherence with regulations, policies, and procedures — and identify potential risk areas.
  • Educating employees: Compliance officers inform employees of the importance of compliance and provide training on relevant regulations and policies.
  • Investigating complaints: When a compliance issue arises, HCOs investigate the matter to identify the root cause and recommend corrective action.
  • Developing corrective action plans: Compliance officers work with leadership to develop and implement disciplinary action plans to address recurring issues.

How To Find the Right Person for the Role

When hiring an HCO, it’s important to consider their skills and qualifications. Compliance officers should have a genuine enthusiasm for the concept and benefits of compliance, a high motivation to ensure organizational accountability, and a strong belief in the efficacy of ethics. They should also possess a natural curiosity about laws, regulations, and standards.

Outside of these soft skills, healthcare organizations will want to look for a variety of hard skills, learned abilities, and educational backgrounds. Certain education and experience requirements are typically expected for an HCO; however, specific qualifications may vary depending on the organization and the scope of the compliance officer’s role.

Find out how to shine in your compliance role.

Education and Certification

Most healthcare organizations require a bachelor’s degree in healthcare administration, business, or a related field. A master’s degree in healthcare administration or a related field may be preferred or required for certain positions. Additionally, some healthcare organizations may require or prefer certifications such as Certified in Healthcare Compliance (CHC) or Certified Compliance and Ethics Professional (CCEP).

Experience

The level of experience required for a compliance officer may vary depending on the size and complexity of the healthcare organization. In general, compliance officers should have experience in healthcare compliance, regulatory compliance, or a related field. They should know relevant laws and regulations such as HIPAA, Stark Law, Anti-Kickback Statute, and the False Claims Act. Experience in auditing, investigations, and corrective action planning is also beneficial.

Desired Skills and Characteristics

In addition to education and experience, specific skills and characteristics are desired for this role. These include:

  • Strong communication skills: Compliance officers must effectively communicate with employees, leadership, and external stakeholders.
  • Analytical skills: Compliance officers should have strong analytical skills to identify potential compliance risks and develop practical solutions.
  • Attention to detail: Compliance officers must have a keen eye for detail to identify potential compliance issues.
  • Leadership skills: Compliance officers should have strong leadership skills to effectively implement compliance programs and communicate the importance of compliance to employees.
  • Ability to work in a team: Compliance officers should be able to work collaboratively with other departments and stakeholders to ensure compliance across the organization.
  • Integrity: Compliance officers must be ethical and honest in their work, ensuring that their organization adheres to ethical and legal standards.

Becoming a compliance officer requires education, experience, and certain skills and characteristics. Healthcare organizations should carefully consider the qualifications of potential candidates when hiring for this critical role.

Hiring a Well-Qualified Compliance Officer

Compliance officers are critical in healthcare organizations because they ensure compliance with all applicable laws, regulations, and policies. Hiring the right person for this role — or upskilling and certification for a qualified in-house employee — is essential to the organization’s success.

Keep in mind that to be effective, the compliance officer should possess healthcare experience, regulatory knowledge, effective communication skills, analytical skills, and attention to detail. They should also have key characteristics such as integrity, leadership, adaptability, problem-solving, and organizational skills to succeed in this position. That’s a lot to ask for in a single candidate; however, it’s what the position demands to ensure success not only for the HCO, but also for the organization.

Support Your HCO With Enterprise Compliance Software

In addition to hiring the right compliance officer, healthcare organizations can benefit from using enterprise healthcare compliance software such as MedTrainer. MedTrainer’s all-in-one compliance platform includes learning, credentialing, documentation, and more. With all documents and policies in one location, they’re easy to find for all employees and automations save time for compliance officers.

Healthcare organizations can remain compliant with all applicable laws, regulations, and policies by appointing an HCO and utilizing the latest compliance technology. Speak with a MedTrainer expert to learn how to streamline your compliance.