Here at Seattle University School of Law, we look at business through a legal lens. But what does that mean for the complex, nuanced business of healthcare?
Seattle University School of Law invited an expert to help define and detail the expanding field of healthcare compliance. David Figueroa is currently the Executive Director of Policy and Awareness at Kaiser Permanente, which is a large, multi-state national healthcare organization. He oversees the creation of national, regional and local policies. His insights from his own real-world experience are widely applicable to anyone looking to break into a thriving, fulfilling career.
Healthcare Compliance Challenges and Rewards
At the heart of healthcare compliance is a mission to help others. “If someone is not getting the care that they need, are they going to still be able to live healthy lives? Are we going to empower them to be the best version of themselves? Can they get care that’s culturally competent in a language they can understand?” David’s work centers around answering those questions.
These are also difficult problems to solve. “The challenges can be just as complicated anywhere you work, but in terms of getting meaning from the work, I think it gets no better than healthcare.” Compliance professionals are trying to help their organization do better work as informed by regulations, advancements, and best practices.
Misconceptions About Effective Compliance and Healthcare Organizations
One common misconception or misunderstanding about compliance is that it holds back an organization’s growth. “We want to understand business problems and help design solutions that not only comply with regulatory concerns, but also help drive the business in a way that is successful,” David reminds us. Compliance has evolved considerably in the past 5 years to keep up with, and even stay ahead of, the forefront in technology, and will continue to do so.
“Something that’s definitely a focus for me is, how does compliance show up in partnership with other parts of the organization, and how do we protect them?” As you get deeper into the work, there are many civil liabilities that could be applied to not only corporations, but also individual leaders, if they’re not acting in a way that’s compliant with regulatory compliance issues. You have to have a solid, strong foundation of compliance skills to stay on top of everything, and organizations truly value leaders with this invaluable skill set.
A Typical Day in a Healthcare Compliance Leadership Role
In his role, David works with the big picture. A typical day includes:
- Checking in on what policies are in queue or overdue
- Initiating action steps on next policies
- Ensure the communication of new or recently published regulations
- Understanding new regulations as they come in.
He also spends the majority of his day in meetings. “I’m thinking about that professional development piece. How do we engage our workforce and help them learn about what’s new and on the horizon? How do we help them be prepared for the next step in their careers?” Organizations need to be on the same page; what the regulation means, how to address it, and the timing of the project to get everything implemented smoothly.
Healthcare Compliance Helps Others
But compliance goes far beyond just enforcing the rules – a compliance career might allow you to exercise a positive, changemaking influence on society. David’s role at Kaiser Permanente is fulfilling in this regard. “We try to support members where they are and give them access to resources, even if they are outside the health system, that might support them in their journey,” he says.
Kaiser Permanente also tackles challenging issues like the gap in healthcare for the unemployed. Other roles at the company, such as on the internal government relations team, are frequently on Capitol Hill advocating for improved healthcare policies and guidelines.
The Necessary Skills to Ensure Compliance
Compliance and legal issues are inextricably interconnected. Legal skill or training is transferable into any career, particularly thanks to the level of detail that legal professionals bring to their problem-solving approaches. For those looking to break into these fulfilling roles in compliance, prioritize these skills:
- Awareness of the rules and regulations around the business of healthcare
- Knowledge of how the different insurance models work
- Communication and plain-language translation
- Critical reading comprehension and information synthesis
- Relationship building and networking.
The best way to learn these skills while advancing your position in the field is to earn an advanced degree. Seattle University’s MLS in Compliance and Risk Management is exactly what you’re looking for.