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SalarySPECIALIST - HEALTH CARE COMPLIANCE AND PRIVACY - ACO
PURPOSE OF CLASS:
In the Office of Healthcare Compliance & Privacy (OHCP), this position assists in the evaluation, development, evolution, implementation, and day-to-day management of the Healthcare Compliance, Privacy, and Integrity Program with a focus on Accountable Care Organization (ACO),by exercising independence, autonomy, accuracy, confidentiality, and integrity.
REPORTING RELATIONSHIP:
Works under the limited supervision of an employee of higher grade and under the general supervision of the Chief Healthcare Compliance & Privacy Officer.with accountability to the Associate Vice President of Populations Health for ACO related responsibilities.
PRINCIPAL DUTIES AND ACCOUNTABILITIES:
Drafts, revises, reviews, and monitors the implementation of written policies and procedures, ensuring alignment necessary for the ACO.
Participates in Program oversight and effective management through committees and workgroups, training and education, outreach programs, and professional development, representing the interests of the ACO.
Evaluates Program risks particularly those pertaining to the ACO, through metrics, monitoring of Program-related regulations, inquiries, and trends, and formalized risk assessment activities.
Participates in OHCP investigations, including those affecting or involving the ACO, to include audit trail reviews, record reviews, interviews of individuals, analysis of policies and/or procedures, and participation with other departments, including Employee and Labor Relations and th ACO's Compliance Department.
Liaises and collaborates with internal and external stakeholders to research and respond to inquiries related to Program requirements, prioritizing those related to the ACO, including preparation of reports, analyses, and recommendations to assist in operationalizing compliance and improving internal controls.
Conducts audits and participates in the development of related corrective action plans, including those related to the ACO and maintains effective mechanisms for frequent, collaborative communication with both the Chief Healthcare Compliance & Privacy Officer and the AVP of Population Health
Performs other duties as assigned.
MINIMUM REQUIRED QUALIFICATIONS:
Knowledge, Skill, and Ability:
Knowledge of foundational compliance and privacy regulations, such as the federal False Claims Act and HIPAA Privacy and Security Rules, as well as common standards, policies, and accreditation requirements.
Ability to follow and implement auditing and monitoring processes, investigative techniques and protocols, and research and analysis skills.
Knowledge of electronic health record systems.
Excellent oral, written, interpersonal, and conflict resolution skills.
Excellent analytical, organizational, and time management skills.
Proficiency in Microsoft Office programs and related tools.
Ability to proactively manage competing priorities, change, and due dates.
Ability to interpret and operationalize healthcare regulations, standards, and policies.
Ability to audit, monitor, and investigate Program-related elements.
Ability to maintain strict confidentiality and integrity.
Experience and Training:
General Experience: Associate degree in a related healthcare field with five (5) years' experience in healthcare compliance, privacy, or direct patient care at a hospital or health system - OR - Bachelor's degree with three (3) years' experience - OR - Master's degree with two (2) years' experience.
OR
SPECIAL REQUIREMENTS:
Incumbent must possess, earn within 18 months of hire, and maintain during employment, a healthcare compliance and/or privacy certification, preferably certifications administered by the Compliance Certification Board.
Schedule - 40 hour work week: Monday through Friday, 8:00 am to 5:00 pm with a 60 minute unpaid meal break.
FULL TIME EQUIVALENT MINIMUM SALARY: $74,683 - $112,025
