Ekaterina V. Jetcheva
Denver,CO
Summary
Experienced executive specializing in patient-focused healthcare compliance and quality performance. Successfully delivered transformative results in various verticals, including pharmaceuticals, medical devices, hospitals, and physician offices. Demonstrated expertise in strategic leadership, implementing effective structures, tools, policies, and procedures to drive improvements in quality, satisfaction, and compliance. Proficient in reviewing, monitoring, and analyzing processes, reporting, and data to identify continuous improvement opportunities.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Head of Compliance and Privacy
VENTRICLE HEALTH
01.2023 - Current
- Responsible for the design, development, and implementation of a robust compliance, privacy, and ethics program to ensure compliance with regulatory requirements as the organization expands across the United States
- Manage and execute all policies and procedures, which govern the company’s compliance, privacy, and ethics program to ensure ethical, safe, and efficient procedures
- Accountable for analyzing commercial, government, and public healthcare policies to identify trends and risks
- Plan and oversee risk assessment deployment to ensure regulatory risk areas are identified and managed timely and appropriately
- Develop and oversee the implementation of the Annual Work Plan and Audit Plan
- Oversee the development and deployment of all compliance and privacy training programs
- Establish Physician Corporations throughout the US to ensure compliance with the Corporate Practice of Medicine (CPOM) regulations
- Oversee the development and implementation of Privacy Program to ensure compliance with applicable data regulations
- Liaise with legal and regulatory bodies on compliance-related matters and lead all regulatory investigations, reporting, and resolution activities
Head of Compliance US
BABYLON HEALTH
01.2023 - 12.2023
- Oversaw development and implementation of Babylon’s Group Compliance program in support of compliance with US federal and state laws, rules and regulations, UK laws and regulations, and other relevant foreign laws governing Babylon’s healthcare and technology operations worldwide
- Provided advisory input to key business areas and identified solutions to advance Babylon’s business interests consistent with compliance with state laws and Babylon’s own policies and procedures related to fraud/waste/abuse laws and regulations, third-party payer rules, Medicare/Medicaid guidelines, Managed Care and other aspects of healthcare and product operations
- Reported regularly on compliance and risk activities, outcomes and escalated concerns to the Audit Committee, Board subcommittees, and Senior Leadership meetings
- Developed and oversaw the implementation of the Compliance Annual Work Plan, Audit Plan, annual risk assessments, and annual training and communication plan
- Led all regulatory investigations, reporting, and resolution activities
- Mentored and managed a large team of compliance and regulatory affairs professionals across the globe
Director of Compliance-Hospital Services Group
DAVITA, INC
01.2021 - 12.2023
- Served as the Compliance Officer for in-hospital dialysis for over 900 hospitals and Chairperson of the Hospital Services Group’s Management Regulatory Committee
- In partnership with Senior Clinical Leadership, oversaw the development, modification, communications, and implementation of policies and procedures to ensure the mitigation of risks in the areas of regulatory compliance, risk management, and patient safety
- Coached hospital staff on how to successfully implement regulatory safety and risk management concepts and guidelines to ensure audit and survey readiness
- Led annual risk assessment process across Hospital Services Group and assessment of annual compliance plan with actions and timelines
- Oversaw the development and implementation of compliance training and monitoring by serving as a change manager to ensure the team’s understanding of 'why'
- Partnered with internal audit teams to design annual audit plans for the business
- Cultivated solid cross-functional collaboration to ensure compliance partnership and efficiency among all teams and departments
Director – Compliance & Quality
ROCKY MOUNTAIN HEALTHCARE COMPANIES (RMHC)
01.2021 - 12.2021
- Provided direction and oversight of the development, implementation, and monitoring of all quality improvement and compliance programs
- Drove quality/compliance initiatives throughout the network to ensure the achievement of strategic and business goals and objectives
- Developed and managed compliance, quality, and risk management dashboards and reports
- Led and maintained compliance and accreditation audit readiness through ongoing training, assessments, KPIs, and Corrective Action Plans
- Oversaw and managed reporting of Performance and Quality Improvement metrics and outcomes to federal, state, and local regulatory agencies
- Conducted annual compliance Risk Assessment and Work Plan
- Collaborated with other departments (Operations, HR, Finance, Facilities, and programs) to direct compliance issues to appropriate existing channels for investigation and resolution
Healthcare Quality Improvement Advisor
COLORADO REGIONAL HEALTH INFORMATION ORGANIZATION (CORHIO)
01.2020 - 12.2021
- Led and directed process and quality improvement initiatives that produced better patient outcomes and more efficient operations for practices and hospital systems
- Guided practices and hospital systems on workflow redesign, team-based care structure, effective use of EHRs, and integrating technology to improve patient safety and care
- Consulted clinics and health systems on accreditation and survey readiness
- Consulted healthcare organizations on value-based contracting, grant programs, and budgeting
- Instructed clients on value-proposition development, contract negotiation, and presentation
- Planned, scheduled, and directed grant deliverables for practices and hospital systems
- Consulted clients on EHR selection, adoption, and migration, as well as Telehealth implementation
- Assisted practices with EHR data validation and workflows including clinical quality measures, registry reports, and meaningful use / MIPS report
Director – Compliance & Quality
ONPOINT MEDICAL GROUP
01.2017 - 12.2020
- Delivered transformational strategy driving implementation and monitoring network-wide compliance program to ensure compliance with the Office of Inspector General (OIG) and devised multiple organizational plans to fulfill requirements and criteria stipulated by federal / state programs and payor organizations
- Led quality assurance, patient safety regulations, OSHA, provider training programs, and CLIA lab certifications
- Governed implementation and monitoring of a comprehensive, network-wide compliance program in alignment with expectations set by the OIG, and modified the Compliance Program to reflect changes, clarifications, or updates in applicable laws, regulations and policies
- Oversaw the clinical transformation process, improving patient outcomes, STARS ratings, team-based care and managed the budgets and all processes for the value-based contracts
- Directed and managed all quality-based programs-CPC+, MIPS, SIM, TCPi, APM Medicaid, Medicare Advantage, and commercial quality incentive programs
- Applied detailed understanding and performed thorough review of regulatory standards and requirements to devise multiple organizational plans to address gaps, risk management, and audited and aligned code of conduct with federal and state programs – Medicare / Medicaid
- Developed and implemented annual communications, training, project materials and tools, monitoring and auditing plans, to ensure all personnel were equipped with the knowledge to support quality, patient safety and compliance, and all tracking and reporting processes were adhered to
General Manager (Director of Operations Equivalent) / Compliance Officer
GOLDIN PHARMACY & MEDICAL SUPPLY / SLEEP DISORDER CENTER
01.2009 - 12.2017
- Oversaw all onsite operations and compliance, budgets of $7.5M+, and up to 44 staff that included Pharmacists, technicians, sales, customer service, and billing
- Delivered astute strategic leadership and direction on all day-to-day operations, identifying areas for improvement, and resolved issues to drive productivity, quality, and compliance
- Worked in close collaboration with the organizations’ legal team to develop and implement a comprehensive compliance program and annual work plan to ensure compliance with regulatory agencies, including Medicare and Medicaid
- Created and maintained robust processes and procedures to secure compliance with federal and state Medicare / Medicaid guidelines
- Efficiently managed the preparation of documentation and location for government audits and onsite inspections for the businesses
- Prepared for rigorous review on all aspects of business to maintain HQAA and AASM accreditation surveys
- Applied financial and business acumen to perform cost-analysis, review financials / budgets daily to identify cost-saving opportunities and track to goals
- Initiated and oversaw investigation of suspected violations of applicable laws, regulations or policies and recommended corrective action (including disciplinary action) where appropriate
- Hired and mentored staff, conducted performance reviews, and identified areas for training and professional development to support achievement of goals
- Fostered, strengthened and sustaining positive relationships with vendors, government entities, physician’s offices, and clients
- Played an integral role reversing revenue loss of around $500K in billing denials due to inadequate policies and processes, by reengineering operations, workflows, and compliance, and introducing and upgrading EMR systems
Education
PhD Candidate - Leadership in Healthcare
South-West University
Blagoevgrad, Bulgaria11.2024
Master’s Degree - Organizational Leadership
Colorado State University
Denver, COBachelor’s Degree - Business Administration
University of Colorado At Denver
Denver, COHealthcare Compliance Certification -
Healthcare Lean Six Sigma Green Belt -
Skills
- Compliance Program Development
- CMS: Medicare / Medicaid; Medicare Advantage
- HITRUST and SOC 2
- Federal and State Healthcare Laws
- Quality Improvement
- Policy & Procedure Development
- Survey Readiness/Accreditations
- HIPAA / OSHA
- Telehealth
- Regulatory Training
- Quality Assurance
- Patient Safety
- Risk Management
- EMR: Epic, Oracle, Athena, eCW, Office Practicum, Kareo
Certification
- Healthcare Compliance Certification (CHC)
- Healthcare Lean Six Sigma Green Belt (LSSGB)
Languages
English
Native or Bilingual
Russian
Native or Bilingual
Bulgarian
Native or Bilingual
Greek
Native or Bilingual
Timeline
Head of Compliance and Privacy
VENTRICLE HEALTH
01.2023 - Current
Head of Compliance US
BABYLON HEALTH
01.2023 - 12.2023
Director of Compliance-Hospital Services Group
DAVITA, INC
01.2021 - 12.2023
Director – Compliance & Quality
ROCKY MOUNTAIN HEALTHCARE COMPANIES (RMHC)
01.2021 - 12.2021
Healthcare Quality Improvement Advisor
COLORADO REGIONAL HEALTH INFORMATION ORGANIZATION (CORHIO)
01.2020 - 12.2021
Director – Compliance & Quality
ONPOINT MEDICAL GROUP
01.2017 - 12.2020
General Manager (Director of Operations Equivalent) / Compliance Officer
GOLDIN PHARMACY & MEDICAL SUPPLY / SLEEP DISORDER CENTER
01.2009 - 12.2017
Healthcare Lean Six Sigma Green Belt -
PhD Candidate - Leadership in Healthcare
South-West University
Master’s Degree - Organizational Leadership
Colorado State University
Bachelor’s Degree - Business Administration
University of Colorado At Denver
Healthcare Compliance Certification -
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