Healthcare Compliance Consultant - Organizational Integrity

PeaceHealth is seeking a Healthcare Compliance Consultant - Organizational Integrity for a Full Time 1.00 FTE Day position. The salary range for this job opening at PeaceHealth is $41.03 - $61.55. The hiring rate is dependent upon several factors including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Job Summary

Using expert knowledge of compliance practices, the Healthcare Compliance Consultant supports the Healthcare Compliance Manager in developing and maintaining the Healthcare Compliance Program for PeaceHealth. The individual in this position is responsible for conducting complex process-related compliance investigations, participating in proactive annual work plan audits, and monitoring related compliance across the system and/or by assigned network or operational specialty area. The Healthcare Consultant is responsible for identifying, assessing, and recommending corrective actions through root cause analysis to support operational compliance with state and federal laws and rules. This position also contributes to the development and maintenance of a compliance program in accordance with the Office of Inspector General (OIG) general compliance guidelines and maintains an effective compliance program based upon the seven elements promulgated by the OIG.

Candidate Must Possess

A minimum of seven (7) years of relevant compliance experience, preferably in healthcare or clinical operations, with familiarity of complex laws and regulations that govern PeaceHealth.

Essential Functions

Implements the PeaceHealth Healthcare Compliance HCC Program for system-assigned network and/or operational specialty areas, including the development, communication, implementation, monitoring, and maintenance of the program by partnering with all levels of caregivers on process-related compliance initiatives.

Manages and conducts process-related investigations for compliance concerns identified by both internal and external reporters related to system issues assigned network and/or operational specialty areas.

Performs annual work-plan audits designed to evaluate compliance risks related to applicable federal, state, and regulatory agencies, laws, and rules, including overseeing those performed by a third-party vendor on behalf of PeaceHealth.

Acts as a liaison between the department and all levels of leadership related to corrective actions resulting from process-related compliance issues to help ensure effective and timely remediations.

Creates and provides reports, presentations, and metrics for all levels of caregivers and leaders about compliance, including routine and ad hoc requests related to system issues assigned network and/or operational specialty areas.

Provides guidance to operational leaders and acts as a trusted advisor for controls, recommendations, and root cause evaluations related to corrective action plans.

Conducts proactive monitoring encompassing key operational compliance activities to evaluate the long-term efficacy of compliance-related controls.

Participates in and/or manages the departments annual risk assessment resulting in the Healthcare Compliance Annual Audit Work Plan, including participating in quarterly updates as appropriate.

Acts as a consultant to operational leaders responsible for developing, documenting, updating, and maintaining departmental-specific compliance programs as needed.

Provides guidance to all levels of PeaceHealth caregivers on process and billing-related compliance questions in partnership with other key areas as needed, such as legal risk, accreditation.

Participates on committees, task forces, projects, and in various meetings.

Performs other duties as assigned.

Qualifications

Education

• Bachelors Degree Required
• Healthcare Administration or equivalent discipline or equivalent skills training and experience
• Masters Degree Preferred

Experience

• Minimum of 7 years Required
• Relevant healthcare or other applicable compliance experience and/or clinical operations experience
• Preferred Experience with the 7-elements of a compliance program
• Preferred Medical records experience

Credentials

• Required within 1-12 years
• Certified in Healthcare Compliance

Skills

• Excellent skills and experience developing and performing core compliance program functions, including investigations, case management, proactive auditing, monitoring, remediations, corrective actions, risk assessments, policies, education, root cause analysis, and controls assessments.
• Required Outstanding verbal and written communications, interpersonal, and leadership skills.
• Required Demonstrated ability to effectively communicate and interact with all levels of leadership.
• Required Ability to successfully navigate difficult conversations and influence staff at all levels.
• Required Strong presentation, data analysis, and report creation skills, including the ability to report out to all levels of PH leadership.
• Required Exemplary moral compass, including unwavering commitment to ethical behavior and confidentiality.
• Required Clear intentional and strategic communicator, including helping caregivers find clarity in compliance-related matters.
• Required Proven ability to thrive in a fast-paced changing environment and successfully manage multiple investigations and projects simultaneously.
• Required Proactiveness and curiosity with the ability to work independently.
• Required Excellent analytical and problem-solving skills.
• Required Advanced skills in all MS Office applications, Word, Excel, Outlook, PowerPoint.
• Required Ability to travel to other PeaceHealth facilities and locations.

Working Conditions

• Lifting
• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects.
• Sedentary work.
• Environmental Conditions
• Predominantly operates in an office environment.
• Some time spent on site in medical/hospital setting.

PeaceHealth is committed to the overall wellbeing of our caregivers, physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are:

• Full medical, dental, vision coverage
• 403b retirement plan, employer base and matching contributions
• Paid time off, employer-paid life and disability insurance with additional buy-up coverage options
• Tuition and continuing education reimbursement
• Wellness benefits and expanded EAP and mental health program

See how PeaceHealth is committed to Inclusivity, Respect for Diversity, and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application.

EEO Affirmative Action Employer Vets Disabled in accordance with applicable local, state, or federal laws.