Corporate Compliance and Privacy Officer

JOB SUMMARY

The Corporate Compliance Officer is responsible for managing the corporate compliance and Privacy Program. Additionally, under the guidance of the Chief Medical Officer, the Risk Management program (which includes comprehensive quarterly risk assessments, internal audits, HRSA mock audits, internal compliance and risk committees, compliance and risk education, adverse event tracking and mitigation and compliance hotline management). This individual also functions as an independent resource from the operational management to evaluate compliance and risk issues/concerns raised within the organization. The Corporate Compliance and Privacy Officer ensures the Board of Directors, management and employees are in compliance with the rules and regulations of regulatory agencies, that company policies and procedures are being followed, and that behavior in the organization meets the company's standards for ethical conduct.

The Corporate Compliance and Privacy Officer acts as staff to the CEO and to the Board of Directors' Quality Committee by monitoring and reporting results of the compliance and risk efforts of the Cooperative and in providing guidance for the Board and senior management team on matters relating to compliance and risk management. The Corporate Compliance Officer is authorized to implement all necessary actions to ensure achievement of the objectives of an effective compliance program. This person also serves as the organization's Privacy Officer consistent with HIPAA (Health Insurance Portability and Accountability Act of 1996).

ESSENTIAL FUNCTIONS

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Supports the Cooperative's mission by striving for excellence in all aspects of their job with a focus on positive interpersonal relationships with co-workers. This is conducted by designing and maintaining high standards, and, through partnerships, education on staff on internal guidelines and those communicated by boards and surveying bodies.
• Maintains, updates, and revises policies, including the Cooperative's Code of Conduct, related to the effective management of the compliance program and its activities. Works closely with the quality assurance team and department leaders to assess the effectiveness of department policies and procedures in maintaining regulatory compliance for each service line.
• Provide regular updates with reports to leadership, the Chief Medical Officer, CEO and Board of Directors on the status of the compliance and risk program.
• Provides oversight and timely guidance of compliance and risk activities throughout the organization. Manages day-to-day operation of the compliance program, including internal and external audits, monitoring and training functions.
• Assesses and prioritizes key compliance and risk areas for the organization and each of its service lines. Develop and maintain scorecards and dashboards to track and display necessary measures to align with an effective compliance and risk management program.
• Assists executive team with the development of performance improvement initiatives related to compliance in their respective areas.
• Supervises the management and coordination of response to third party audits and external inquiries related to regulatory compliance.
• Analyzes audit findings and external reports and assessments and provides recommendations for corrective action plans.
• Responds to compliance allegations by evaluating or recommending the initiation of investigative procedures and oversees a system for uniform handling of such allegations.
• Supervises the implementation and management of audit functions, including external regulatory review and/or audits in collaboration with executive team.
• Acts as an independent review resource to ensure that compliance concerns and investigations are being appropriately evaluated, addressed and resolved.
• Manages and develops compliance staff and assists in the development of regulatory accreditation staff
• Omission of specific duties does not exclude them from this position if the work is similar, related or a logical assignment for this position.
• Ensures appropriate risk management procedures are in place to reduce the risk of adverse outcomes that could result in medical malpractice or other health or health-related litigation.
• Facilitates the creation of and implementation of policies and procedures that minimize risk and promote patient and employee safety.
• Serves as a standing member of the Cooperative Health Continuous Quality Improvement and Risk Management Program (QRM).
• Works with the QRM Committee to develop annual risk management goals.
• Works with the QRM Committee to develop, implement, and monitor an annual health care risk management training plan for all Cooperative Health employees.
• Assists with the submission of Cooperative Health's Federal Tort Claims Act (FTCA) application.
• Participates in personal annual risk management training.
• Perform other related duties as required for the smooth running of the department.

QUALIFICATIONS

• Bachelor's degree required. Master's degree preferred.
• 3+ years of experience in health care compliance required. 5+ years of experience in health care compliance in a management capacity preferred.
• Highly prefer a Certification in Healthcare Compliance (CHC) or must obtain within 15 months of hire.
• Knowledge of, and experience with, patient privacy laws and regulations, including but not limited to HIPAA and South Carolina privacy laws and regulations.
• Working knowledge of regulatory and billing compliance for FQHCs as well as knowledge in physician practice billing is preferred.
• Knowledge of Risk Management investigation and mitigation.
• Knowledge of state and federal regulations, Medicare and Medicaid and third-party payer regulations and guidelines

SUPERVISORY RESPONSIBILITY

• Health Information Management Specialists
• Safety and Risk Coordinator
• Healthcare Quality and Risk Coordinator
• Compliance and Risk Support Specialist

COMPETENCIES

• Demonstrated investigatory skills, including document review and interviewing people as part of ongoing investigations.
• Advanced computer skills with proficiency in Excel, Word, and Power Point. Experience with Compliatrics.
• Must have ability to analyze data and make data driven strategic decisions.
• Must possess outstanding interpersonal relationship skills.
• Must be able to travel to various practice sites.

COMPANY CONFORMANCE STATEMENT

In the performance of their respective job assignments all employees are expected to conform to the following:

• Cooperative Health's policies and procedures.
• Cooperative Health's confidentiality and professional provisions
• Cooperative Health's compliance program
• Cooperative Health's standards of conduct

Supervisory responsibility

• Yes

Cooperative Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Cooperative Health complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfers, leaves of absence, compensation and training.