Director - Revenue Compliance at Mayo Clinic (2024)

Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation andcomprehensive benefit plans– to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting diversity, equity and inclusion, and provides the resources you need to succeed.

This position promotes oversees employee education, monitoring and auditing, enforcement, incident response and prevention as required to sustain compliance with Mayo Clinic policies and applicable laws and regulations. This role also serves as the lead internal resource for all compliance-related issues relating to revenue generation, regulatory requirements of Medicare and Medicaid participation, and payor inquiries.Provide strategic expertise and direction to Mayo Clinic regarding payer, regulatory and compliance initiatives. Represent Mayo Clinic at national conferences. Serve as a key member of the leadership team with primary focus on administrative leadership, management of allied health staff, operational and strategic planning, and implementation of policies and systems. Relied upon as the expert on payer policy, collaborating across Mayo Clinic on developing strategic plans.

Key focus areas include hospital and professional billing, fraud and abuse prevention, transplant program compliance, laboratory billing compliance, regulatory interpretation of Medicare Conditions of Participation and Conditions for Coverage, Telemedicine, and compliance with Accountable Care Organization requirements. As part of the Revenue Compliance program, the Director – Revenue Compliance will: (1) perform an annual compliance risk assessment for the identification and mitigation of revenue cycle risks; (2) review and disseminate external payor reports to practice and departmental leaders; (3) investigate and respond to audits and inquiries brought forward by government agencies and commercial payors; (4) manage Revenue Cycle Compliance Subcommittee in partnership with the Revenue Cycle Compliance Medical Director, and Compliance Operations meetings, minutes, and follow up; (5) maintain revenue compliance dashboard; (6) manage revenue-related hotline calls and compliance logs; (7) review requests related to hospital discounts, patient assistance policies, and gifts; (8) review proposed practice and vendor arrangements for possible false claims, Stark, Anti-Kickback, inducement, and other concerns; (9) conduct fact-gathering as needed from internal departments and external vendors; (10) represent Mayo Clinic’s Integrity and Compliance Office at various institutional meetings, including serving as the Compliance Officer for Mayo Clinic’s Accountable Care Organization; and (11) provide revenue compliance education to physicians and allied health staff, and address questions from clinicians and administrative leaders.

Affirmative Action and Equal Opportunity Employer