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Provides management & leadership over Compliance, HIPAA & Risk.

Location:
Santa Clarita, CA
Salary:
$230,000-$245,000
Posted:
April 02, 2024

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Resume:

ARLAYN M. LADSON-CASTLE, JD

***** *. **** ***** *****, Santa Clarita, CA 91390

Phone: 661-***-**** ad4qgj@r.postjobfree.com

Seasoned Executive successful at building and leading high-performance teams; Motivated by challenges and regarded for effective and seamless implementation of key corporate initiatives that aid profitability, productivity and quality; Acknowledged for successfully managing and leading cross-functional teams; Strategic and creative thinker with global perspective. Commended throughout career for developing streamlined policies and procedures aligned in the industry; Championed for the integration of compliance & privacy principles, standards and practices; Expert in executive training, mentoring and being a platform speaker. Ability to make difficult decisions impacting the fate and bottom line of organizations.

PROFESSIONAL STRENGTHS & ACCOMPLISHMENTS

Championed for successful Compliance & Privacy Program Implementation, Enforcement and Oversight

Leadership and management over Compliance, HIPAA & Privacy, Quality Improvement, Risk Management Credentialing and Contract Development & Negotiations

Strategic Planning, Building & leading cross-functional teams,

Executive Trainings and Presentations, Visionary regarding Organization and Change Management

Thrust business growth and revenue by developing and implementing effective SOPs, policies procedures and process improvements; substantially improved contract negotiations.

Exceed Expectations

Received Employee of the Year Award & Presidential Leadership Award

EDUCATION

Juris Doctorate, Southern University Law Center

Bachelor of Arts, Psychology and English, Dillard University

BUSINESS EXPERIENCE

*Sonic Healthcare USA (Clinical and Anatomical Pathology laboratory services) 6/2021 – present

Director, Compliance and Privacy

Reporting to the President, I serve as the Head of Compliance & Privacy for the California Division of Sonic Healthcare; responsible for developing and implementing a robust effective enterprise-wide Compliance, Ethics and Privacy Programs; investigate, mitigate and resolve compliance and privacy issues and ensure that all reportable breaches are reported to OCR; provide in-person customized Compliance and Privacy training to employees (with a focus on Stark law, Anti-Kickback Statute, Fraud & Abuse general compliance); Develop and implement policies regarding CCPA and CPRA; Knowledge of GDPR & EKRA; serve on the Sonic Leader Board Committee as a liaison with the corporate office in Australia. Lead the Compliance and Privacy Committee; Perform auditing and monitoring in various aspects. Collaborate with company stakeholders on various company strategies and issues; Develop, draft, review and/or negotiate contracts (including Patient Service Center leases, Laboratory and Phlebotomy Services Agreement, and Managed Care Agreements; work very closely with the Sr. VP, Managed Care to ensure compliance with contracts,; ensure CLIA and CAP accreditations and licensure compliance; Perform risk management throughout the California division (saved the company over $1,000,000 my first year with the company); Responsible for dealing with governing agencies and regulators such as CMS, OCR, CDPH and HHS as appropriate and serve as Sonic Australia’s liaison for keeping California leaders abreast of communications and new strategies on the international front; work closely with Security Officer on Security Risk Assessments and key Security safeguards. Ensure that all sites have up-to-date business licenses and that subpoenas for patient records are managed and responded to timely. Approve advertisements and promotional items. Engage in presentations to leadership; Provide intermittent reminders to employees regarding the importance of Compliance and Privacy; Devise policies, Create Compliance & Privacy champions throughout the organization. Oversee credentialing with payers and provide leadership over Enterprise Risk Management. Participate in M&A, Due Diligence processes. Ensure sanction screenings are performed monthly. Work with Billing to reconcile claims pursuant to RAC and ZPIC audits.

*CURATIVE, INC. (A Medical Device Establishment) 9/2020 – 6/2021

Compliance & Privacy Officer

Reporting to the General Counsel and heading up Compliance and Privacy for Curative throughout the United States, I was responsible for designing and establishing an effective global Compliance, Ethics, and HIPAA & Privacy program for an extremely fast-paced start-up entrepreneurial organization. Devise Compliance, HIPAA, and Privacy policies and procedures (including for CCPA), investigated compliance, HIPAA, and privacy issues, resolve and mitigated, OCR reporting, drafted consents, prepared customized Compliance, Ethics, HIPAA & Privacy training for 4,000 employees throughout over 8,000 sites. Serve as the subject matter expert on all Compliance and Privacy and issues. Drafted contracts and collaborated with the Legal team, Field Operations, Operations, Sales, Human Resources, and IT on various issues. Head the Compliance and HIPAA/Privacy committee and present reports in leadership meetings. Hire train, manage, and mentor employees. Perform audit of sites to ensure employees were following company policies; performed site audits throughout the United States and worked closely with finance in connection with insurance billing, Collaborated with Marketing on social media issues regarding privacy, CCPA knowledge, and Direct dealings with Regulators such as FDA, CMS, OCR and HHS.

*NORTH LA COUNTY REGIONAL CENTER (Developmentally Disabilities Agency) 6/2019- 9/2020

Compliance/HIPAA Privacy & Contracts Management

Reporting to the Deputy Director-CFO, I was responsible for creating and building an effective HIPAA Privacy Compliance program for a fast-paced organization. Also provided leadership and management over cross-functional teams (Compliance/HIPAA, Quality & Contracts) as well as the following:

• created and implemented an enterprise-wide Compliance and HIPAA Privacy program

• Provided education and training to all employees and vendor service providers to effectuate a solid awareness of laws and regulations in connection with corporate compliance & HIPAA; and Devising policies and procedures.

• spearheading and establishing Compliance and HIPAA Committee.

• engaging in presentations with leadership and the Board of Directors regarding laws affecting consumers with disabilities.

• ensured that all operations contracts were drafted and negotiated to protect the company’s interest.

•reviewing and approving Subpoenas requesting consumer records and working with outside counsel for protective orders as applicable. During the COVID-19 pandemic, I was instrumental in ensuring that (i) the organization used HIPAA-compliant technology for patient services and (ii) that employees were provided with guidance & reminders in connection with the protection and security of PHI while working remotely within the various technological formats including Teams, Slack & Skype. Drafted and negotiated vendor contracts and presented at Executive Management meetings on various compliance and privacy topics.

*ACUITY EYE GROUP (Physician owned & professionally managed full-centered Ophthalmology Group)

Vice President, Contracts and Chief Compliance Officer 8/2017 to 2/2019

Reporting to the President and the Board of Directors, I provided leadership and management over cross-functional teams including Corporate Compliance and ethics, HIPAA Privacy and security (knowledge of GDPR), Quality Assurance & Performance Improvement, Internal Audits, Enterprise-wide Risk Management, Credentialing & Contracts. Created & effectively implemented an Ophthalmic Compliance, Ethics & HIPAA Privacy & Security program throughout the organization (including 4 ASCs) and a Full Enterprise Risk Management program. Chaired the Compliance & Ethics and Privacy Committees, Ensured that organization’s vitamins were properly labeled; Implemented & maintained a quarterly audit program resulting in successful outcomes from external audits of regulators and insurance payors; Engaged in ongoing risk analysis and assessments to ensure full protection of the organization; Established a robust end to end contracting process (including timely review, negotiation, tracking & monitoring of contracting responsibilities & the dissemination of contract Fact Sheets); Negotiated high level contracts (including Physician Practice Acquisition Agreements and Vendor Agreements); Drafted all policies, consents & other documentation; Provided ongoing education & training to employees on relevant on Stark, AKS and other laws, policies and procedures governing their responsibilities; then tested to ensure proficiency; Conducted internal investigations & collaborated with HR on corrective actions; Resolved, tracked & trended patient grievances; then trained employees which resulted in 80% less grievances & litigation; Ensured processes were in place for optimal patient safety; tracked incident reports, Ensured IIPP was updated & trained employees resulting in employees being more proactive and aware. Collaborated with all department heads and worked closely with Human Resources on (i) employment laws, and (iii) Updating the Employee Handbook and with IT regarding security and privacy matters. Participated in M&A Due Diligence matters.

* PACIFIC CLINICS (Advancing Behavioral Health)

Chief Compliance Officer & Corporate Director of Contracts 1/2011 to 8/2017

COMPLIANCE & Quality

• Reporting to the President and CEO and the Board of Directors, I was responsible for developing the infrastructure establishing and successfully implementing the Compliance, HIPAA and Ethics Program throughout the agency which consists of 85 sites for the provision of services to consumers with mental health & substance abuse issues.

• Compliance and educational trainings of staff on updates and laws (including, but not limited to HIPAA, Medicare & Medi-Cal Regulations the False Claims Act, the Stark Law, FCPA, Anti-bribery and Anti-kickback Statute), CMS regulations and OIG guidance affecting Healthcare Compliance.

•Responsible for ensuring that all sites meet certification and accreditation requirements, conducting

Compliance audits, monitoring of policies and procedures; assessing, monitoring and measuring risks.

Worked very closely with Human Resources on HR compliance issues and lawsuits.

•Assist with drafting updates to the Employee Handbook and Human Resources policies.

•Developing trusting relationships with staff which resulted in more ethical and compliance complaints.

• Engaging in Strategic planning with the Executive Management Team.

• Investigating issues and ensuring effective policies and procedures are in place for consistency; ensured medical necessity requirements were met prior to billing, etc.

• Working closely with Human Resources on the non-retaliation policy and on Compliance sanctions.

• Promptly investigating all good faith ethical and Compliance complaints and recommending corrective action plans; Engaging in direct dealings with Regulators.

• Instrumental in achieving CARF accreditation by governing the risk management process agency wide and Medi-Cal certification of all sites.

• Responsible for mitigating risk and performing sanction/exclusion checks.

Serve on the Human Resources Policy Committee and Chaired the Risk Management, Quality & Safety Committee and the Compliance and Ethics committee.

CONTRACTS

• Responsible contracts compliance and for reviewing, developing and negotiating all agency contracts; ensuring low risks and liability to company; ensuring adherence to post award obligations and assisting the Federal Head Start program in the RFP/grant process.

• Chair of the Corporate Compliance Committee and Consistency & Accountability Committees.

• Successfully collaborating with internal and external business partners; and Providing leadership over cross-functional teams (Compliance, Contracts, HIPPA and Quality) and serving as the organizations legal Compliance resource.

Knowledge of Knox-Keene; Negotiated agreements for services in connection with Manage Care (Cal Medi-Connect)

Serve on numerous committees: Medical Advisory Committee, Strategic Leadership Committee, 403 (b) Fiduciary and Leadership Committee, IRB, etc.; Chaired: Corporate Compliance Committee and the Consistency and Accountability Committee.

SIGNIFICANT ACCOMPLISHMENTS:

Spearheaded & worked very closely with LA Housing Authority and City Attorney & City Council members and Obtained City Council approval to forgive $8,000,000 in Community Redevelopment loans.

Engaged the Physicians & Nurse Practitioners in participating in Meaningful Use Incentive Program (for utilizing the organization’s EHR system resulting in a net revenue of approximately $5,000,000.

Instrumental engagement in the acquisition of the organization’s physical health affiliate.

Worked closely with the State of California (EHAP) for the transfer & sale of a $1,500,000 home to house homeless mothers & children while linking to valuable services (i.e., physical & mental health services, training & educational guidance).

*UNIVERSITY OF SOUTHERN CALIFORNIA (Higher Education & Health care)

Director, Clinical Trials Management & Compliance 3/2008 – 1/2011

• Reporting to the President of the Division, I performed leadership, management and oversight over Contracts, Budgets, Accounting and Project Management Teams, Ensuring (i) Clinical Trials compliance at the Keck School of Medicine, Budget and Accounting Compliance and (ii) quality of care for patients.

• Reviewed and approved all contract and budget negotiations and perform all escalated negotiations.

• Writing and implementing SOPS, procedures, processes and methods of contracts compliance.

• Developed and effectively facilitated department goals in continuity with company goals.

• Training, professional development and mentoring employees.

• Engaged in Board & IRB executive meetings & presentation regarding ICH GCP, HIPPA regulations involving Informed Consents for Clinical Trials & Clinical Trial protocols; and FCPA, Anti-bribery, etc.

• Maintained successful relationships with internal and external clients.

*AMGEN INC. – (A World Pioneer in Biotechnology)

Sr. Specialist, Law, Development and Regulatory Affairs 11/2005-11/2007

• Streamlined negotiations by developing and implementing contract negotiation playbook.

• Performed contract development negotiations and budget negotiations.

• Promoted to provide management and leadership to staff of 8 within the first six (6) months of

employment; Trained and provided professional development.

• Contributed to scientific clinical study meetings to ensure studies complied with FDA approval for drug indications; interacted with hospitals, universities and physicians, (including those internationally based).

• Researched and applied federal regulations and guidance in connection with clinical trials.

• Reviewed and approved sponsor advertisements, informed consents and HIPAA documents.

References available upon request



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