This is a senior management position reporting directly to the CEO and Board of Directors with the principal authority and responsibility for developing, implementing, and evaluating the Compliance Program for the organization. This position provides oversight and direction for compliance with applicable federal and state rules and regulations and internal policies and procedures. This position is also responsible for providing leadership and driving results for the department including leading internal and external audits by performing the following duties.
- Coordinates, supervises, and supports the organizations compliance-related programs, such as compliance training, compliance testing and reporting, and contingency planning.
- Leads internal and external audits and monitors corrective action plans developed from those audits.
- Develops an annual risk assessment and implements an annual compliance work plan based on the assessment.
- Manages the organizations policy and procedure repository and ensures annual reviews of all policies and procedures are completed.
- Provides Compliance updates to the CEO, Compliance Committee, and the Board of Directors from time to time.
- Provides leadership direction and oversight as needed to ensure successful implementation, execution and adherence to the compliance regulations and guidance with the Oregon Health Authority contract and ATRIO Service Area Contractor agreement.
- Examines organization policies, procedures, and practices to ensure compliance with federal and state rules and regulations.
- Coordinates with legal counsel and internal departments to ensure adherence to laws and regulations relating to new or revised products and services.
- Oversees the revision, preparation, and dissemination of new and updated compliance standards and procedures.
- Conducts internal compliance audits and informs the Compliance Committee of audit results.
- Identifies potential compliance vulnerabilities through various methods, including risk assessment, audits and ongoing monitoring and reports the issues to the CEO and Compliance Committee.
- Develops annual plans for monitoring and auditing the effectiveness of the Compliance Program and compliance with regulatory and contractual requirements which includes but is not limited to standards, policies, procedures, and legal requirements.
- Develops and implements corrective action plans for the resolution of problematic issues.
- Develops and delivers compliance and regulatory program training for new employees and new contractors regarding their responsibility for compliance and regulatory requirements.
- Educates and encourages utilization of the “Compliance Hotline” to facilitate prompt reporting of possible compliance issues.
- Investigates and follows up on matters that are reported through the “Compliance Hotline” or other confidential internal reporting mechanisms.
- Tracks and trends compliance issues that are identified through the “Compliance Hotline” or other means, to anticipate, mitigate and prevent potential vulnerabilities going forward.
- Maintains expert working knowledge of applicable Federal and State regulations, including Medicaid requirements under Oregon law and Federal requirements under Title XIX of the Social Security Act and supporting regulations.
- Monitors healthcare regulatory environment for emerging trends of compliance.
- Acts as a resource for policy and procedure development and implementation to maintain regulatory compliance.
- Leads the preparation and presentation to the Compliance Committee.
- Prepares and presents compliance dashboards and regulatory reports.
- Maintains confidentiality and complies with HIPAA rules and regulations.
- Maintains punctual, regular and predictable attendance.
- Works collaboratively in a team environment with a spirit of cooperation.
- Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working withmembers and coworkers, including the ability to communicate effectively and remain calm and courteous under pressure.
- Respectfully takes direction from manager.
EDUCATION and/or EXPERIENCE
Bachelor's degree from four-year college or university; and five to seven years related experience and/or training.
COMPUTER SKILLS
Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, report writing, project management, graphics, word processing, presentation creation/editing, communicate by e-mail and use scheduling software.
CERTIFICATES, LICENSES, REGISTRATIONS
Certification in Health Care Compliance (CHC) is preferred.
We provide a competitive salary and excellent benefits, including vacation, medical, dental and vision insurance, and 401(k) pension plan. To apply for this position, please submit a cover letter and resume. We are an Equal Opportunity Employer.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
Work Location: Hybrid remote in Klamath Falls, OR 97601