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Healthcare Compliance and Privacy Manager

2 months ago

Rochester, Minnesota, United States Olmsted Medical Full time

1.0 FTE

At Olmsted Medical Center, we prioritize our workforce and are dedicated to offering a comprehensive and competitive benefits package. To adapt to the changing landscape, Olmsted Medical Center provides the following benefits for employees working at a 0.5 FTE or higher.

  • Medical Insurance
  • Dental Insurance
  • Paid Time Off
  • Vision Insurance
  • Basic Life Insurance
  • Tuition Reimbursement
  • Employer Paid Short-Term and Long-Term Disability
  • Adoption Assistance Program

Qualifications

  • Bachelor's or master's degree in a relevant field is required.
  • A minimum of 5 years of experience in a healthcare setting is essential.
  • Certification in Healthcare Compliance (CHC) is preferred or must be obtained within 2 years of employment.
  • Supervisory experience is mandatory.
  • Current Minnesota Registered Nurse license is preferred.
  • Familiarity with healthcare legislation, the Medicare program, regulations, and standards is necessary.
  • Knowledge of reimbursement compliance, auditing, monitoring, and performance enhancement is required.

Position Overview

  • The Compliance Officer directs and oversees the Compliance and Privacy Program.
  • This role has a dotted line relationship to the Board of Trustees and may report compliance issues directly to the Board.
  • Establishes and implements an effective compliance and HIPAA privacy program to identify, rectify, and prevent illegal, unethical, or improper conduct.
  • Collaborates with Human Resources to address staff misconduct.
  • Implements a retaliation-free internal reporting mechanism, including anonymous reporting options.
  • Develops and maintains an Enterprise Risk Management System.
  • The Compliance Officer serves as the HIPAA Privacy Officer and is responsible for ensuring compliance with HIPAA and the Minnesota health records act, overseeing patient privacy policies, managing sensitive information, and ensuring investigations of privacy complaints.
  • Acts as the Section 1557 of the Affordable Care Act Coordinator.
  • Works with the Compliance Committee, organizational and physician leadership, department supervisors, and directors in an oversight capacity, authorized to implement necessary actions to achieve effective compliance and HIPAA privacy objectives.

Key Responsibilities

  • Serves as the Chair of the Compliance Committee.
  • Is knowledgeable in federal regulations and collaborates with physician and organizational leadership to ensure compliance.
  • Develops, initiates, maintains, and revises policies and procedures for the effective operation of the compliance and HIPAA privacy program and related activities, managing day-to-day operations.
  • Periodically reviews and updates the organization's Code of Conduct and other compliance-related policies to ensure ongoing relevance in guiding leadership and employees.
  • Collaborates with and assists officers, directors, and supervisors in administering the compliance and privacy program.
  • Consults with legal counsel as needed to resolve complex legal compliance issues.
  • Investigates alleged violations of rules, regulations, policies, procedures, and the Code of Conduct, making independent determinations regarding violations.
  • Ensures confidentiality of all reports of suspected violations and investigations.
  • Develops and oversees a uniform system for handling such violations.
  • In conjunction with Human Resources, recommends disciplinary actions for code violations as per established policies.
  • Identifies potential areas of compliance/privacy vulnerability and risk, developing and implementing corrective action plans in collaboration with organizational leadership.
  • Provides regular reports to the Compliance Committee, board, and senior management on compliance efforts, claims, and claim payments.
  • Ensures proper reporting of violations or potential violations to authorized enforcement agencies as required.
  • Directs and manages the anonymous compliance reporting systems and departmental web page, maintaining an effective compliance communication program, including promoting:
    • Use of the compliance hotline and website for reporting suspected violations.
    • Increased awareness of the organization's Code of Conduct.
    • Understanding of new and existing compliance issues and related policies and procedures.
  • Develops and facilitates regular compliance training programs, including introductory training for new employees and ongoing training for all employees and leadership to promote understanding of the code and corporate compliance, with at least annual training for Board of Trustees members and volunteers.
  • Ensures all employees receive the code.
  • Maintains a file of all training sessions and attendance records.
  • Conducts periodic audits of employees, departments, administration, or offices to ensure compliance with the code.
  • Stays informed about changes in state and federal laws, rules, and regulations that may impact program implementation.
  • Makes recommendations to the CEO and the Board of Trustees regarding changes to the program to enhance compliance with the code.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or discriminate against employees or applicants for inquiring about, discussing, or disclosing their own pay or the pay of another employee or applicant. However, employees with access to compensation information as part of their essential job functions cannot disclose the pay of other employees or applicants to individuals without access to that information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR c)