Compliance Today - October 2021

Determining fit

The first question to ask when outlining a career path in compliance is determining whether the healthcare compliance profession is the right fit for you. Many prospective compliance professionals are attracted to the profession because they enjoy reading and interpreting the law and helping organizations implement those laws. There are dynamics that go much deeper than simply applying legal requirements that can make the position challenging that are important to understand before you embark on a career in compliance.

Understanding your work style, preferences, strengths, and skills is important to determine whether you’re a good fit for the compliance role. For example, if you’re interested in a role that has a high degree of consistency and predictability to it, the compliance role may not be an optimal fit as the compliance officer works in a highly dynamic environment with a constant need to reprioritize.

Alternatively, if you like to constantly learn new things and get involved in many areas of the organization in a never-ending array of disparate activities, you might be a good fit for healthcare compliance. Understanding the dynamics of the compliance profession is important to understand whether the role is right for you.

Finding the right niche

This speaks to the proverbial question of “What do you want to be when you grow up?” One of the essential questions is what specific role do you want to be in. Although the chief compliance officer may seem enticing, there are many other roles that are equally rewarding. These might include compliance education, auditing and monitoring, investigations, privacy or security, clinical research, etc. There are also some very compelling sister roles to compliance like risk management, quality, accreditation, legal, or internal audit.

Finding the right industry

What aspect of the industry would you like to work in? If we limit our considerations to the healthcare industry, this might include hospitals, health plans, home health and hospice agencies, physician groups, durable medical equipment or device companies, the pharmaceutical industry, etc. There are many niches within the healthcare industry where compliance plays a role, and you’ll want to decide which niche you’d like to pursue. This decision might be made for you as future opportunities become available that are of interest.

Finding your preferred geographic location

This may represent one of the most important factors to consider when mapping your compliance career. Is there a specific geographic location you’d like to work in? It’s important to consider the availability of the compliance profession in the geographic location of your choice. If your desire is to remain in the small town you grew up in, your options for compliance positions may be limited. If, however, you choose to work in a large metropolitan area, your career options expand considerably. Having said that, working in a small town may be the right choice for you. In some cases, people are limited in their geographic options due to personal factors.

The best way to move up quickly in your career progression is, of course, to be willing and able to relocate to where the next best job is. If you choose to stay in a specific geographic location, you may be qualified for the chief compliance officer position but end up waiting years for that golden opportunity only to discover that someone from outside your area was offered the position and the waiting game begins again. This isn’t to dissuade you from desiring a specific location or organization; just be aware of those constraints and limitations.

Increase your competency and knowledge

Much of the credibility of the compliance officer’s role revolves around their knowledge of legal and regulatory requirements. Knowing the requirements of certain key laws applicable to the organization you work for will be key to your success. Few things will diminish the credibility of a compliance officer faster than giving bad advice.

Master the high-level framework of healthcare compliance

This includes having a working knowledge of the U.S. Sentencing Guidelines, including the seven elements of an effective compliance program. Much of your time will be spent around these seven elements, so it’s important to know what they are and how you can most effectively implement them in your organization. If you work for an organization for which a compliance program guidance document exists, as published by the Office of Inspector General (OIG) of the Department of Health & Human Services, you’ll want to have a working knowledge of those documents.

Stay abreast of the latest trends in compliance risk, enforcement activities, new laws, or regulations

You’ll want to have a steady stream of incoming information to enable you to stay on top of this dynamic field. Subscribe to journals, periodicals, newsletters, or magazines informing you of the latest in healthcare compliance. Find reputable law firms that specialize in healthcare and join their listservs. These firms frequently send out emails and publish white papers on the latest information and offer tips for compliance. Professional associations offer numerous educational seminars and training offerings.

Sign up for listservs or follow social media pages of government enforcement agencies. The Department of Justice and the OIG both have Twitter pages that communicate updates on their activities. Government enforcement agencies have adopted these technologies not only to increase awareness of enforcement activities, but to make the clarion call of prominent risks, which can help you prioritize your compliance efforts.

Know your organization

In addition to understanding applicable legal requirements, you also need to understand how to incorporate those laws most effectively into the fabric of your organization. Master your organization’s operations, including the size of the organization and its component parts and divisions. Understand the services, clients, and customers who are served by your organization. Get to know the people who work in and for your organization. Understand the reporting structure, organizational chart, and politics and governance of your organization. Understand how decisions are made and who has both formal and informal authority in your organization. The most effective compliance professionals understand the leverage points of success in their organizations and how to achieve optimal outcomes and results.

Communicate your intentions

Let your direct supervisor know that you have an interest in progressing your career and ask them what you can do to accomplish that. This step isn’t necessarily asking for an immediate promotion, per se, as much as seeking advice on the best approach to getting a promotion in the future. If they don’t know you’re interested in moving up, they might pass you up for someone else who was assertive enough to express an interest—and they may not even be as qualified as you. One side effect of communicating your desire to moving up is your superiors will know that if they don’t find an opportunity for you in the future, someone else might, and they could run the risk of losing you to another organization.

Be visible—in your organization and in the industry

Make yourself known. Be visible in meetings and projects, not just as an attendee but as an active participant. Let people see you as an agent for positive change and a voice at the table. People will take your compliance program more seriously when they view you, and the program you represent, as an active part of the organization. Make sure that the compliance function is represented at key multidisciplinary meetings. There’s nothing wrong with inviting yourself to the table—the worst they can do is say no, but at least you’ve offered to lend your voice to the conversation and they know that you stand ready to be a part of organizational progress. People usually don’t say no to those who have a genuine and constructive desire to be a part of the team.

External to your organization, get your name out there in the broader healthcare compliance community. Make sure you have a LinkedIn profile with a professional photo. LinkedIn is currently one of the most used tools by professional recruiters, as resumes are readily accessible and searchable.

Get involved in the industry

Volunteer in professional associations. Volunteer to sit on a committee or planning events where you can get greater exposure to those in the industry. Present a topic at a conference, a webinar, or some other training event. Author an article for Compliance Today. Draft a white paper on a topic of interest. One strategy to secure a speaking opportunity or publish an article is to partner with someone who has more experience than you or who may be better known in the industry and jointly present or author an article with them.

Networking is one of the best ways to move up in the compliance industry. It will take substantially longer to work your way up in the field if you rely solely on internal promotion or the random executive recruiter call. You’re much more likely to be referred to a new and exciting opportunity by someone who knows you, who has worked with you, and who has experienced your value versus a cold call from an executive recruiter. A professional referral also gets placed higher on the stack for consideration since you’re a “known entity.”

Obtain experiences

Get involved in all seven elements of your organization’s compliance program. If you’ve been hired to work as a compliance auditor and you find yourself only engaged in audits, ask your supervisor if you can participate in other aspects of the program, even if you’re just a fly on the wall in key meetings. As a full-fledged compliance officer, you’ll need to have a working knowledge of all seven elements, so getting involved in other areas will be important to learning the ropes. Become familiar with the policies and procedures that govern the various elements of your compliance program that you may not be otherwise directly involved with.

Ask your superiors to let you draft policies and procedures. The exercise of drafting policies and procedures forces you to learn how to apply legal principles to operational practice and allows you to practice negotiating certain operational constraints against those legal requirements. It’s easy to write a policy or procedure, but working with the leaders who own the operational processes is a good experience to becoming a compliance officer. If your organization ever receives a notice from the government that it’s going to be audited for a compliance or privacy matter, ask to be involved in the process. You’ll want to have a working knowledge of how to conduct a government audit. Learn how to conduct a proactive audit and apply monitoring techniques. This would include learning how to write an audit scope, understanding sampling techniques, becoming familiar with how to use the OIG’s RAT-STATS tool, drafting audit reports, reporting findings to key process owners, and calculating a net reimbursement error rate.

Ask to attend a governing board meeting where compliance activities are reported. A critical function of the compliance officer role is to report in governing board meetings. Presenting to a governing board is as much of an art as it is a science. You will want to master the approach to reporting to the board. There are political considerations you’ll need to understand when reporting to the board. Attending board meetings will give you an opportunity to learn how to read the room, understand those who are in power positions, what their hot buttons are, and how to best approach a reporting relationship with them.

Seek opportunities to train others on compliance topics and initiatives. We never learn principles better than when we teach them. The aspect of answering questions in a training environment is just as valuable in honing your training skills and ensuring that you become a skilled instructor.

Understand the psychology and politics of compliance

You’ll be faced with many situations where you’ll need to navigate potentially challenging situations where there is resistance to compliance, and it’s important to understand when and why it occurs. The compliance officer’s most valuable soft skills are those of negotiation, persuasion, and motivation. So much of what we do in the compliance profession is based on risk tolerance versus the strict letter of the law. Most laws, especially federal laws, must be applicable to large audiences. It’s difficult to write a law that is perfectly applicable to every situation; therefore, laws are often broad-sweeping recommendations. Given this, you must navigate a wide range of potential risks when achieving compliance. How well you can do that will dictate how successful you will be in the role. Learn how to read the room. When seeking support for a compliance principle or addressing a compliance matter, know who your champions, supporters, resisters, and detractors are so you can customize your message to the audience most effectively.

Gain as much business acumen as you can. If you become the chief compliance officer, you’ll likely be running a department. It will be important to know how to manage people, create and manage a budget, run a staff meeting, etc.

Obtain one or more professional credentials

It goes without saying that obtaining one or more credentials in the healthcare compliance industry will help you achieve your ultimate career goals. There are numerous compliance-related credentials in the industry from a variety of associations. The Certified in Healthcare Compliance (CHC) is one of the most widely recognized certifications for healthcare compliance officers. Obtaining a credential doesn’t necessarily make you a better compliance officer. It does, however, serve several important purposes. It demonstrates to the world that you have mastered a body of knowledge related to the industry. It holds you out as someone who has declared themselves committed to the compliance industry. It shows that you keep yourself up to date through ongoing education to maintain your competency. In some ways, holding a credential may seem like a rite of passage, but it’s necessary to move up in your career. Those hiring senior compliance professionals (typically senior operational leaders like a CEO) likely don’t know what it takes to be a competent compliance officer. They rely, in part, on your credentials as a measure of your competency.

Prove your worth

The compliance industry is very competitive. Set yourself apart from the crowd. Show others that you are worthy of moving to the next stage of your career. When opportunities arise, your superiors will look for those who have demonstrated their worth and are ready to take on greater responsibility. That means you may need to burn some midnight oil or work occasional weekends. Showing that you are willing to make some personal sacrifices for the success of the organization and the program demonstrates you can be trusted to get the job done.

Become a master communicator

So much of the success of a compliance professional lies in how well they can work with others, and that often means having strong communication skills. This includes in-person communication; facilitating group discussions toward a meaningful and productive outcome; and writing professional, concise, empathic, and diplomatic emails. Take classes on facilitation skills, public speaking, group problem solving, Six Sigma or Lean strategies if they’re offered to strengthen your communication and problem-solving skills.

Learn to lead, both formally and informally

It’s often the informal leader that gets the next best opportunity in an organization. You don’t need direct reports to be an effective leader. As a chief compliance officer, you may even be faced with situations where you need to be a leader to those superior to you, including senior management and the governing board. Understand what it takes to be a leader and how to carry out the role most effectively. Strive to gain the respect of the senior leadership team. Avoid adopting a “no” attitude. Sometimes no is the right answer, but try to find ways to get to no through a yes. Instead of saying that something can’t be done because it’s noncompliant, offer alternatives to how the desired objective could be accomplished while still achieving compliance. This will go a long way in positioning you as a valued partner with those who may have a voice in your future promotion.

Know your resources

HCCA is the premier professional association for healthcare compliance professionals. It offers many of the resources presented above, such as networking opportunities, volunteer opportunities, offering presentations and writing articles, and staying abreast of the latest compliance information. HCCA also offers a direct access to job opportunities through its Jobs Board webpage.^[1]

Find peers and mentors to give you advice

Learning from others can be an expressway for promoting your career. Learn from the experience of those who have gone before you so you don’t repeat the mistakes of the past. Give back by being a mentor to others. Regardless of the stage of your career, you can pass along the things you’ve learned to others.

Practice your job interview skills

The best way to be a successful interviewee is through practice. Do this routinely so when a prime opportunity arises, you’ve had some recent experience walking through the interview process.

Always keep your professional résumé updated and readily available

Update it with any new roles, projects, experiences, and accomplishments so it can be produced at a moment’s notice. Have your résumé reviewed by someone else to make sure it’s readable and meaningful to your career objectives.

The strategies suggested in this article may seem like a tall order. You don’t need to adopt these strategies all at once. Choose a few strategies that you believe will best enhance your career immediately and identify others as you master them.