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How to Become a Healthcare Compliance Officer

April 1, 2021
April 1, 2021

The website Investopedia shares that “A few years ago, The Wall Street Journal labeled compliance officer the hottest job in America” (Investopedia, 2018). It goes on to offer that “In terms of importance and financial impact, chief compliance officers rank among chief financial officers (CFOs) and chief executive officers (CEOs) on some executive staffs, since a proper compliance environment keeps Uncle Sam at bay and represents a noticeable advantage over less-prepared competitors” (Investopedia, 2018).

Compliance positions are available across many industries, but job duties and responsibilities for compliance officer positions are similar, regardless of where you work. Primarily, a compliance officer must ensure an organization is being run legally and ethically, and complying with all applicable industry regulations. This job duty begins with an in-depth understanding and analysis of current regulations for the industry in question. Compliance officers must be able to interpret regulations and their fit into organizational operations.

What is Healthcare Compliance?

According to Michigan State University (MSU), “Healthcare compliance is about a healthcare facility or organization maintaining compliance with a number of government agencies, acts, guidelines, and laws. But the role of compliance goes beyond knowing these laws and regulations to the letter and ensuring a healthcare organization complies with them. A major responsibility of healthcare compliance is to conduct investigations and audits to identify areas of risk, draft a plan for improving compliance practices to address those risks, and monitor to ensure the program is following best practices and standards” (MSU, 2018). Typically a healthcare compliance officer must also set up a training program to ensure all employees understand how to meet their compliance obligations.

Education and Training

The compliance officer position is not typically deemed as entry-level. A Bachelor degree is typically a minimum requirement, and some positions may require an advanced degrees, like a law degree or an MBA. Healthcare compliance officers may be required to hold certifications, such as Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified in Healthcare Research Compliance (CHRC), and Certified in Healthcare Compliance - Fellowship (CHC-F). According to the Health Care Compliance Association (HCCA), “The rigorous standards and professional conduct required for certification demonstrate a diligent effort on the part of the compliance practitioner, and verifies broad-based knowledge in the discipline being tested” (HCCA, n.d.). These exam-based, two-year certifications require regular renewal thereafter via continuing education.

Skills and Qualifications

It is recommended that all compliance workers have analytical, investigative, and decision-making skills. Other desirable professional orientations include detail orientation and a bent towards strategic planning. According to Investopedia, “No two compliance officers face the exact same challenges, and the nature of the job is such that every officer becomes a perpetual student: Regulatory changes take place on a consistent basis” (Investopedia, 2018)

Unique Demands of Healthcare Compliance

MSU advises that patient protection is just as important as patient care, with that responsibility squarely on the shoulders of the healthcare compliance function—from protecting patients’ personal information and maintaining proper billing practices to ensuring that provider operations meet all legal requirements. The MSU article quotes Dr. Michael Rip, Program Director of the Master of Science program in Healthcare Management at Michigan State University, who adds, “Lack of oversight and a failure in compliance can cost an organization millions,” says “There’s a huge need in hospital compliance, and good, agile leadership is critical” (MSU, 2018).

Careers in Healthcare Compliance

The outlook for healthcare compliance careers is very promising. MSU shares that “Due to the many government agencies, acts, and regulations healthcare organizations need to adhere to, healthcare compliance is an area of critical demand with a need for knowledgeable subject matter experts” (MSU, 2018). The range of healthcare ranges across the continuum, and from public to private and non-profit organizations. Likewise, the size of a healthcare compliance function at an organization can vary widely—from a single person or small team to an entire division headed by a healthcare compliance officer.


Learn more about HCCS Solutions for healthcare compliance training.

References

Health Care Compliance Association (HCCA). (n.d.).Become Certified. Retrieved at https://www.hcca-info.org/certification/become-certified

Investopedia. (2018). How to Get a Job in Compliance. October 7, 2018. Retrieved at https://www.investopedia.com/personal-finance/how-to-get-a-job-compliance/

Michigan State University. (2018). Career Opportunities in Healthcare Compliance. July 5, 2018, Retrieved at https://www.michiganstateuniversityonline.com/resources/healthcare-management/career-opportunities-in-healthcare-compliance/