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Compliance Manager

RCS - Administration | Frontera Crossing Office, ATX | Full Time

Job Description

This position oversees the Corporate Compliance Program by independently and objectively reviewing and evaluating compliance issues within the organization. Serves as the final internal resource to receive and resolve compliance issues/concerns.

  • Develop and oversee control systems to prevent or deal with violations of regulatory guidelines and internal policies
    • As it relates to incident management ‐ interface with Senior Information Security Officer to ensure that data and technology security issues conform and are supported by HR and operational policies governing the protection of privacy of sensitive data.
  • Evaluate the efficiency of controls and improve them continuously
    • Support the process of workflow validation which includes HIPAA compliance and the testing of workflows for compliance to policy and procedures.
  • Revise procedures, reports etc. periodically to identify hidden risks or non-conformity issues
    • Develop, initiate, maintain and revise revenue cycle policies and procedures to ensure compliance with applicable regulatory and legal requirements as well as good business practices.
    • Provide guidance and support to business units to meet operational needs while maintaining compliance standards.
  • Collaborate with Compliance Officer and HR departments to monitor enforcement of standards and regulations
  • Assist in any compliance and/or security audit/inquiry.
  • Support the assessment of client selection and vendors to identify possible compliance risks
  • Review the workflows of revenue cycle staff to identify compliance issues or risks and provide training
  • Coordinate with Senior Information Security Officer and Compliance Officer to update employee security and HIPAA training program, as necessary.
  • Coordinate with Senior Information Security Officer and Compliance Officer to plan and co‐lead certain HIPAA and security awareness trainings.
  • Maintain expertise on compliance trends through training, research and development in order to mitigate potential exposures.
  • Manage incident reporting program and prepare reports for senior management and external regulatory bodies as appropriate and supported by Compliance Officer
  • Participate in the development, implementation, and ongoing compliance monitoring of all business associate agreements to ensure that all privacy concerns, requirements and responsibilities are addressed.
  • As it relates to the company as a whole ‐ responsible for Risk Management Program.
  • Establish and oversee formal risk analysis of business practices.
  • Develop internal controls and strategies to mitigate identified risks.
  • As it relates to the company as a whole ‐ perform risk analysis and self‐assessments program for various interdepartmental processes.
  • Perform risk analysis and self‐assessments program for various interdepartmental processes with Senior Information Security Officer.
  • Ensure legal/regulatory compliance and contract compliance
  • Maintain current and accurate tracking records/systems related to notice of action letters.
  • Participate in other project management and compliance activities as assigned to meet departmental and company objectives and requirements.
  • Assist in promoting awareness related to information privacy and security and enforce compliance with applicable state and federal laws

Education:

  • Bachelor's Degree in Health Care Administration, Business Administration or compliance certification is preferred; Minimum of five (3) years Healthcare experience or training

Qualifications:

  • Proven experience with revenue cycle workflow auditing and training
  • Knowledge of the industry’s standards and regulations
  • Excellent knowledge of reporting procedures and record keeping
  • A business acumen partnered with a dedication to compliance
  • Methodical and diligent with outstanding planning abilities
  • An analytical mind able to “see” the complexities of procedures and regulations
  • Sound knowledge of Federal IT Compliance Standards
  • Extensive knowledge of established and changing healthcare regulations
  • Knowledge of coding and reimbursement systems, risk management and performance improvement
  • Experience in behavioral health environment a plus
  • Excellent communication skills