Increased federal and state regulations to combat fraud, waste and abuse have led to a relatively new job category in health care.

Compliance officers are charged with developing policy and making sure that their organizations adhere to the guidelines that govern health care. They also work to reduce mismanagement and waste.

Compliance officers come from a variety of backgrounds, including attorneys and nurse administrators. It's a challenging job that requires the ability to see the big picture while paying attention to details.

Catherine Futch, MN, RN, CNAA, CHE, CHC, is the compliance officer for Kaiser Permanente's Georgia region. In 1999, she moved to the job from her position as senior nursing leader to guide the development of the company's compliance program.

"The overall goal is to assure that your organization understands its accountability for conducting business and delivering clinical care with ethics and integrity," she said. "It guards against fraudulent insurance claims, improper relationships between providers, hospitals and various health care entities. First and foremost, compliance regulations protect patients and members, our employees and providers, and our employers."

Since January 2000, all managed-care organizations are required to have compliance programs that include a code of conduct and written guidelines to ensure that federal regulations set by the Centers for Medicare and Medicaid Services are met. As the first compliance officer for Georgia region of Kaiser Permanente, Futch worked from the ground up to help create the company's code of conduct and compliance guidelines.

Futch, who has worked in health care for nearly 40 years, has a background that includes orthopedics, neurosurgery, rehabilitation and general surgery. Throughout her career, she has been involved in ensuring that standards of some kind were met. When federal regulations began applying the compliance model to managed-care organizations, it was a natural fit for Futch.

"At that time, no one was really trained in compliance issues, but compliance officers have grown into the role since 2000," she said. "All health care entities are involved in the process of increasing accountability -- from physicians to administrators, the organization's business practices, laboratories, radiology departments -- anyone who represents the organization. As compliance officers, we need to be sure that everyone in all areas of the organization knows the regulations and follows them."

Established within the last few years, the Healthcare Compliance Association has connected compliance officers across the nation to provide forums for developing policies and ways to stay informed about regulations and resources. The group offers formal training and certification; Futch was among the first in the nation to become certified in health care compliance through the association.

Compliance officers' work covers the creation of the institution's compliance documentation, the development of systems to protect against fraud or waste, and the day-to-day education of staff, providers, administration and patients to ensure that business is being conducted ethically and in keeping with established standards.

"It's a delicate balance to ensure that your organization is compliant with applicable rules and regulations while respecting the need for the organization to conduct its business," Futch said. "It's important to build relationships in such a way that individuals will be willing to address compliance issues and concerns."

Futch said that being detail-oriented and working well with people are important skills for the job. The typical entry-level salary can range from $80,000 to $120,000.

While having a compliance officer is not required in many health care organizations, the Centers for Medicare and Medicaid Services strongly recommends that impacted organizations implement a comprehensive compliance program. Not doing so may result in fines, penalties and other sanctions for organizations that don't adhere to regulations.

"They're beginning to understand that not having a compliance department can have negative consequences," Futch said. "The benefits of having an effective compliance program far outweigh the amount of work involved."