Job Description

Job Description: Our client is seeking a healthcare compliance officer associate. Job Responsibilities Reporting to the Chief Compliance Officer, the Compliance Officer is responsible for ensuring that the Company's Compliance processes are implemented consistently and effectively across the organization. As the compliance leader and subject matter expert, the CO is responsible for establishing standards and implementing procedures to ensure that the compliance programs throughout the organization are effective and efficient in identifying, preventing, detecting and correcting noncompliance with applicable laws and regulations. Example responsibilities include;

• Define the necessary level of knowledge on regulatory compliance requirements across the organization.
• Develop and periodically revise the annual compliance work plan to reflect the organization's unique

characteristics and changes. • Oversee the implementation of the compliance program, including HIPAA Privacy and Security requirements.

• Guide the compliance and Information Security teams professionally and productively.
• Provide training and educational programs to enhance understanding of laws and regulatory requirements.
• Offer strategic direction to the management team and Compliance Committee regarding the Compliance

Program.

• Prepare and present concise compliance reports to the Board Committee.
• Interact with regulators on compliance issues as needed.
• Coordinate audits, reviews, and examinations.
• Develop policies that encourage reporting of suspected fraud without fear of retaliation.
• Conduct internal compliance reviews and monitoring activities, including periodic departmental reviews.
• Independently investigate compliance-related matters and monitor external review processes.
• Manage investigations from the compliance hotline and report Compliance Program KPIs to the Compliance

Committee.

• Coordinate Information Security activities with the internal InfoSec Operations Manager.
• Apply Medicare/Medicaid regulatory requirements relevant to clients associate.
• Evaluate the effectiveness of the compliance program on a recurring basis.
• Develop working relationships with clients to ensure proper compliance with CMS

reporting(CDAG/ODAG/ODR/CDE).

• Review plan policies and procedures for compliance prior to RFP document submission.
• Support the creation and updating of monitoring metrics for ongoing compliance assessment.
• Demonstrate in-depth knowledge of the healthcare industry, including fraud, waste, abuse audit operations,

and claims handling and payment operations. • Other duties as assigned or requested Qualifications

• Bachelors' Degree minimum.
• 5+ years of experience in a Compliance leadership-related role for either a CE or another Business

Associate.

• Software programming/Information security, software security experience strongly preferred
• Working knowledge of healthcare laws, rules, regulations and/or regulatory compliance; experience

conducting legal/regulatory research preferred

• Experience in managing government program (Medicare/Medicaid) compliance
• Healthcare Compliance (CHC) and/or HIPAA Privacy (CHPC) certification strongly recommended/preferred
• Working knowledge of MS-Office, Visio, MS-Project, Adobe Acrobat; Policy Tech by Navex Global experience a plus. Aegistech

Job Tags

Similar Jobs