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MGR COMPLIANCE

MGR COMPLIANCE

Job Description



Position Summary:

Preferred Education: Bachelor's Degree in Healthcare Management, Accounting, Finance, or a Related Discipline.


Develop clinical components' compliance plans and monitor clinical component practice to ensure ongoing regulatory compliance. Activities are performed in coordination with HSC Compliance Program. Ensures adherence to Hospital and Departmental Policies and Procedures. No patient care assignment.

Related Education and Experience may be substituted for one another on a year for year basis.


Job Requirements


Accountability:

  • AUDIT - Draft compliance audit programs, conduct audits, review reports, and present to the various Boards. Determine appropriate population and sample sizes
  • COMPLIANCE - Assist in drafting the compliance annual work plan and risk assessment for the Health System
  • AUDIT - Oversee compliance audits and ensure the development of corrective action plans, as necessary
  • INVESTIGATE - Oversee the investigation of possible compliance issues and/or practices, and ensures the development of corrective action plans, as necessary, for the non-compliance areas
  • COMPLIANCE - Document compliance activities and communicate to management and governing boards regarding compliance audit findings via reports and oral presentations
  • AUDIT - Coordinate independent audits of various Health System operations for proper compliance with government regulations
  • COMPLIANCE - Understand Medicare Part A and Part B regulatory environment and its application to coding & billing. Research legal, regulatory, and compliance issues that impact the Health System. Remain current on legal and regulatory compliance issues
  • AUDIT - Track and perform risk based assessment over areas to audit and re-audit
  • COMPLIANCE - Respond to internal questions regarding compliance issues through the provision of guidance and expert interpretation of regulations
  • POLICIES - Assess the Health Systems practices and help develop policies, standards, procedures and guidelines to ensure compliance with Healthcare laws and regulations
  • INQUIRIES - Log all inquiries, inquirers and responses
  • COMPLIANCE - Participate as an active member of HSC Compliance Program Committee to ensure compliance process is functioning as required. Participate in RAC committees and various Health System compliance committees
  • TRAINING AND EDUCATION - Interact with legal counsel, medical and other clinical staff, and employees within the Health System organization to review initiatives and educate initiatives on regulatory compliance
  • BUDGET - Assist the Executive Director with Compliance Department budget
  • COLLABORATE- Coordinate and collaborate with entity compliance officers and internal audit staff
  • OFFICE WORK - Coordinate the daily office function and supervise staff
  • DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops

  • Education Requirements:

  • Bachelor's Degree in Accounting, Finance or related discipline

  • Experience Requirements:

  • 3 years internal/external auditing

  • Physical Demands Requirements:

  • Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

  • Licensure/Certification Requirements - Preferred:

  • Licensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico
  • Certification Health Care Compliance (CHC)
  • Certified Professional Coder or Certified Professional Coder - Hospital

  • Professional Licensure:

  • Licensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico
  • Certification Health Care Compliance (CHC)
  • Certified Professional Coder or Certified Professional Coder - Hospital

  • Working Conditions Requirements:

  • No or min hazard, physical risk, office environ




  • Job Snapshot

    Employment Type Full-Time
    Job Type Health Care
    Education None
    Experience None
    Manages Others No
    Industry Healthcare - Health Services
    Required Travel Not Specified
    Job ID 12271448CBP
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    MGR COMPLIANCE


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