Sr Compliance and Privacy Specialist

Summary:

Under the supervision of the Director of Privacy and
Compliance Operations (Director) serves as a subject matter expert regarding
the HIPAA Privacy Act; maintains the HIPAA Privacy Log performs security
breach analysis and reviews and revises Privacy policies. Plans directs and performs investigations
annual and ongoing Conflict of Interest Disclosure appraising compliance with
general and specific compliance policies and federal and state rules and
regulations. Reviews physician
consulting contract questions in relation to Stark and Anti-Kickback
regulations and Lifespan policies. Prepares reports analyses and
recommendations to assist management in ensuring compliance privacy and best
practices in relation to policy implementation.
Under the Directors direction assumes primary responsibility for the
Compliance Programs confidential employee reporting telephone line (Response
Line) and serves as the Lifespan Privacy Auditor.

Responsibilities:

Consistently applies the corporate values of respect honesty and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly geographically accessible and high-value services within the environment of a comprehensive integrated academic health system. Is responsible for knowing and acting in accordance with the principles of the Lifespan Corporate Compliance Program and Code of Conduct.

Responsible for independently performing and directing compliance audits in accordance with generally accepted auditing standards including tests of accounting billing and medical records and other investigational procedures as deemed necessary. Investigates summarizes and advises Compliance leadership on substantive hot linecomplaints.

Assists Compliance leadership in maintaining Lifespans Privacy Program by ensuring that sufficient procedural guidance and training has been developed; relevant policies have been created employees are following these policies and are receiving required training; documentation of compliance is being maintained etc. Provides Privacy training as required reviews and updates Privacy training ensures employees are receiving this training etc.

Responds to technical questions from the entire Lifespan workforce regarding HIPAA Privacy Act compliance by performing the necessary research. Maintains the HIPAA Privacy Log. Assists the Director and Vice President in performing required breach analysis and federally mandated reporting.

Reviews potential electronic HIPAA privacy violations with third party software as contracted by Lifespan and tracks the review investigation and corrective actions (if any) monthly and annually.

Prepares reports regarding area of responsibility as directed by Director and/or Vice President.

Assists in developing Privacy policies and procedures implementing and interpreting same as needed and guiding staff in consistent application of same. In absence of the Director and Vice President serves as Privacy resource person to employees at assigned Affiliate and cross coverage with other Sr. Compliance & Privacy Specialists also will coordinate all departmental activities. When required works in concert with members of Lifespans Revenue Compliance and internal and outsourced Internal Audit Services.

Develops and completes Compliance and Privacy investigation reports and ensures all appropriate documentation is maintained in secured shared drive and/or on Compliance reporting software so that sufficient competent and evidential matter is obtained. Where applicable maintains workpapers to protect attorney client privilege.

Performs weekly onsite rounding at designated hospitals physician groups and other Lifespan entities to provide scheduled training participate in Environment of Care Rounding and establish themselves as a resource for staff.

Responsible to develop agenda and educational materials for quarterly Compliance Update meetings at all Lifespan assigned Hospital and Physician groups geared to leadership (President CMO CNO HIM) Agendas and discussions are based on data driven analysis and proactive education regarding regulatory compliance guidance.

Provide education and training at least quarterly at assigned Lifespan Hospitals and Physician Groups to share Compliance and Privacy guidance related to Lifespan policies and or trends in issues reported to Compliance as identified through data analysis trends.

Research federal and state laws inspects financial records observe work processes and procedures makes inquiries and confirms application of controls and policies to afford reasonable basis for objective opinions regarding compliance with the laws.

Prepares written reports for the Director factual findings and recommendations. (Level and quality of report and recommendations would normally require minimal revision.)

Assists the Vice President and the Directors in completing the annual risk assessment and annual compliance activity reports and validating the accuracy of compliance self-assessments.

The Senior Compliance& Privacy Specialist who is designed the lead for the annual Conflict of Interest Survey facilitates the annual conflict of interest survey process develops and ensures deployment of the annual compliance training; and manages the Conflict-of-Interest Committee. This individual also manages and provides the annual report on the annual Conflict of Interest Survey to the System Compliance Committee at its September meeting.

This designated individual assists the Vice President on tracking Conflict of Interest questions in queries and investigations and serves to learn as much detail on the subject to serve as the subject matter expert on Conflict-of-Interest matters.

Analyzes data as required for specific reporting of Privacy and Compliance matters.

Cooperates with regulatory third party external auditors and consultants. Reviews results of test checks and other findings to identify areas requiring further examination. Collaborates as needed to discuss findings of special problems.

Functions as resource to others in matters related to compliance and privacy auditing activities.

Maintains and enhances professional knowledge through participation in and affiliation with appropriate professional associations.

Performs other related duties as required.

Other information:

BASIC KNOWLEDGE:

Bachelors Degree in health care management accounting finance business administration or related field; or Advanced degree in Business Law etc. is preferred.

Demonstrated evidence to obtain Certification in Healthcare Compliance (CHC) or Certification in Healthcare Privacy (CHPC) from the Healthcare Compliance Association within eighteen months of employment.

Knowledge of investigative techniques attention to detail in documentation is required.

Specific knowledge of Compliance federal and state laws pertinent to a health care system is preferred.

Knowledge of the HIPAA Privacy Act and the HIPAA Security Act; Compliance rules and regulations with strong written and verbal communication skills.

Strong follow up skills are required.

EXPERIENCE:

Minimum of three years of Corporate Compliance/Privacy Program/Health Information Services experience or a minimum of three years of investigatory experience preferably in a similarly complex health care environment or experience equivalent to three years of patient financial services or legal to demonstrate broad-based knowledge of health care operations and federal and state laws.

Demonstrated written and oral communication skills problem solving skills group presentation skills and project management skills and personal computer application skills is essential.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Normal office environment.

INDEPENDENT ACTION:

Perform independently within Lifespans administrative policies and procedures referring unusual problems to the Director of Privacy and Compliance Operations.

SUPERVISORY RESPONSIBILITY:

None.