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Compliance Manager

4 months ago

Philadelphia, United States Spectrum Health Services, Inc Full time
Job DescriptionJob Description

Job Summary:

The Compliance Manager assists the Chief Compliance and Privacy Officer with the development of the seven (7) elements of an OIG/HHS effective Compliance program and the on-going management of the program. Develops tools to periodically assess compliance effectiveness at Spectrum Health Services.

The Compliance Manager will assist and support the compliance functions of the organization through:

  1. Analysis of Internal Business Processes
  2. Policy Development and Implementation
  3. Risk Management Identification and Strategies
  4. Employee Training
  5. Cross-Functional Collaboration

The Compliance Manager will assist with monitoring progress and conducting confidential investigations of diverse scope into allegations of violation of law, Spectrum's Code of Conduct, or company policies. This role has direct responsibility for conducting compliance investigations from the initial assessment of allegations to completing investigative summaries and reporting investigation outcomes.

Additionally, the Compliance Manager will be responsible for daily operational functions of the core elements of the organization's compliance functions and work with Chief Compliance and Privacy Officer on matters needing escalation and resolution. Compliance Manager will also assist with preparation for the (1) Compliance Employee Committee (2) Spectrum Board Quality Committee and (3) Spectrum Board Committee. The Compliance Manager will need to be able to interface cross-functionally across the organization.

Competencies:

Technical Skills Reporting and Analysis Process Oriented

Supervision Data Visualization Project Management

Delegation Detail Oriented

Problem Solving Team Building

Decision Making Knowledgeable of healthcare processes and business regulations

Communication-verbal

Essential Functions:

  1. Compliance Oversight
  • Assist with the development and maintenance of a robust corporate compliance program for Spectrum that mirrors the 7 elements of an effective corporate compliance program.
  • Manage and support Spectrum's compliance with Federal laws (FWA, OSHA, HIPAA, HITECH etc.), HRSA Health Center Program regulations and Spectrum payors.
  • Serve on committees, and work groups, representing the Compliance Department.
  1. Policies and Procedures
  • Develop and maintain all compliance policies associated with accreditations.
  • Serve as a resource for other departments for developing compliant operational processes.
  • Implement compliance programs, policies and procedures designed to ensure compliance with all applicable federal laws, regulations and delegation requirements.
  1. Compliance Education and Training
  • Support the compliance training programs on a day-to-day basis, ensuring timely completion of on-boarding and topic specific training and education by the workforce.
  • Assist with creating and overseeing educational materials.
  • Provide compliance educational and training offerings
  1. Lines of Communication
  • Respond to hotline calls and incident reports relevant to Spectrum business operations.
  1. Audit and Monitoring
  • Perform tasks related to external audits from contracted health plans, local and federal entities.
  • Conduct standard random audits and focused audits to determine compliance to departmental standards.
  • Identify and assess risks within the organization and develop strategies to mitigate these risks; work with various departments to implement risk mitigation strategies and monitor their effectiveness.
  1. Enforce Standards
  • Assist with communicating and publicizing consequences of non-compliance
  1. Investigations and Corrective Actions
  • Investigate all compliance concerns and coordinates follow up with a corrective action plan as needed.
  • Perform related duties as required

General Information

  • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
  • Communicates clearly and effectively to other employees and vendors, payors and patients.
  • Develops constructive and cooperative working relationships with others and maintains them over time.
  • Encourages and builds mutual trust, respect, and cooperation among team members.
  • Exemplifies the Spectrum's mission, vision and values and acts in accordance with Spectrum's policies and procedures.


Qualifications/Experience:

  • Bachelor's degree in business administration, Healthcare Administration, or related field or 3+ year experience in Healthcare or regulatory fields
  • Strong knowledge of industry processes and regulations.
  • Previous work in healthcare industry.
  • Outstanding communication and interpersonal abilities
  • Some regional travel required; infrequent national travel possible



Benefits:

Medical w/vision

Dental

Paid Time Off

Sick time

403b