Understanding The Vital Role of Healthcare Compliance Officers

As healthcare organizations navigate an ever-changing regulatory landscape, compliance with laws, regulations, and policies has become more important than ever. Defining the role of healthcare compliance officers is critical in ensuring that organizations meet these requirements. But while it might seem obvious, not every organization truly understands the question, “What is a healthcare compliance officer?” — both the scope of their oversight and what they do.

Let’s discuss the role of the healthcare compliance officer in an organization: defining duties, how they work with compliance specialists, how to find the right person for this role, the characteristics and skills needed to be successful in this position, and how software from a top-rated compliance company like MedTrainer can improve your overall program.

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What Is a Healthcare Compliance Officer?

A Healthcare (Hospital) Compliance Officer (HCO) is a professional responsible for maintaining adherence 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 this healthcare compliance job 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 specialist does to create compliance across the board.

In the simplest terms, a medical compliance officer’s job is to make sure 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 and remediating them.

While the healthcare compliance officer owns the entire program and compliance strategy for the organization, the compliance specialist executes within it. A compliance specialist is another healthcare job that is more tactical and hands-on, often responsible for identifying non-compliance (expired policies, incomplete training, billing inconsistencies, etc.). Typically, the compliance specialist role requires between three and five years of experience.

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: Medical compliance officers “define” healthcare compliance in a workplace by creating programs so that their organization complies with all relevant laws and regulations.
• Monitoring compliance: A compliance officer also monitors the organization’s adherence to regulations, policies, and procedures — and identifies potential risk areas.
• Educating employees: Healthcare 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 Can You Hire the Right Person for the Role of Healthcare Compliance Officer?

When hiring an HCO, it’s important to consider their skills and qualifications. Healthcare compliance officers should have a genuine enthusiasm for the concept and benefits of compliance. They should be highly motivated by the organizational accountability and efficacy of ethics in the healthcare compliance job. Compliance officers also need to 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 a compliance officer managing specialists or specialists assisting with compliance; however, specific qualifications may vary depending on the organization and the scope of the compliance officer’s job.

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 medical compliance officer career may vary depending on the size and complexity of the healthcare organization. In general, HCOs 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/or corrective action planning is also beneficial.

Desired Skills and Characteristics

In addition to education and experience, specific skills and characteristics can go a long way for the role of healthcare compliance officers. These include:

• Strong communication skills: HCOs must effectively define healthcare compliance by communicating with employees, leadership, and external stakeholders.
• Analytical skills: Medical 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: HCOs 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 compliance specialists, other departments, and stakeholders to maintain compliance across the organization.
• Integrity: Healthcare compliance officers must be ethical and honest in their work so that their organization adheres to ethical and legal standards.

A career as a compliance officer requires education, experience, and certain skills, such as openness to using online healthcare compliance software. Because of its ease of use, MedTrainer’s compliance platform is preferred by healthcare professionals who want the best experience.

Hiring a Well-Qualified Medical Compliance Officer

Compliance officers are critical in healthcare organizations because they help maintain compliance with all applicable laws, regulations, and policies. Hiring the right healthcare compliance officer — 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 healthcare compliance position demands for the success of the organization.

Support Your Healthcare Compliance Officer With Easy-to-Use Enterprise Compliance Software

In addition to hiring the right medical compliance officer, healthcare organizations can benefit from using software from a top-rated compliance company. MedTrainer is the leading provider of some of the best compliance training solutions, setting up your healthcare compliance officer for success. 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 healthcare compliance officers.

Healthcare organizations can remain compliant with all applicable laws, regulations, and policies by appointing a healthcare compliance officer and utilizing the latest technology. Now that you know what a compliance specialist is and what a compliance officer does, you’re better equipped to find the right one.

Speak with a MedTrainer expert to learn how to streamline your healthcare compliance.