JOB DESCRIPTION

General Job Title: Compliance Officer

Department: Organization Services

Basic Function and Scope of Responsibilities:

We are looking for a qualified individual to serve as Compliance Officer to oversee and manage all compliance and legal activities of the company. This individual will ensure the company functions in a legal and ethical manner while meeting its business and healthcare goals. The role will be responsible for developing compliance programs, reviewing company policies, and advising management on possible risks. The successful candidate will safeguard our reputation by guaranteeing the company strictly follows legal guidelines and give legal advice to management about all relevant issues.

The individual in this role will contribute to the development, implementation and maintenance of system-wide compliance programs, policies and procedures as well as assists and provide counsel to Executive leadership in regard to overall practice risk mitigation.

Principal Responsibilities:

• Resolve employee and/or patient concerns about legal compliance or complaints;
• Advise management on the company’s compliance with laws and regulations;
• Ensure all employees are educated on the latest regulations and processes;
• Create and manage effective action plans in response to audit discoveries and/or any potential compliance violation;
• Create and manage internal policies and procedures;
• Regularly audit company procedures, practices, and documents, to identify possible weaknesses or risks;
• Access company operations to determine compliance risk;
• Research and evaluate different risk factors regarding business decisions and operations;
• Apply effective risk management techniques and offer proactive advice on possible legal issues;
• Create and maintain internal and external forms to conform with changing laws and regulations;
• Ensure compliance with all HIPAA and OSHA laws;
• Manage the relationship with Next Generation Accountable Care Organization and any future accountable care relationship through either hospital system or CMS and serve as the representative for Mission Cancer + Blood
• Compile data to facilitate both internal and external audits.
• Abstraction of information from medical record charts.
• Efficiently and successfully manage projects from start to end.
• Communicate and educate staff and providers on established procedures.
• Ensure all policies and procedures are implemented and well documented.
• Perform occasional internal reviews; identify compliance problems that call for formal attention.
• Develop risk management strategies to avoid non-compliance and file compliance reports with regulatory bodies.
• Establish, mandate and implement standard policies, procedures and best practices across the company to promote compliance with applicable laws and contractual obligations.
• Conduct legal and/or regulatory research and monitor changes in requirements to mitigate risks and achieve compliance.
• Monitor key compliance indicators identified through internal and external resources.
• Research and draft responses to inquiries received from regulatory agencies and clients.
• Work with delegated entities (internal and external) and internal oversight teams to ensure problems are consistently resolved.
• Demonstrate flexibility, availability, and dependability to conform to position responsibilities and department needs.

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

Education requirements:

• Sound judgment and ability to analyze situations and information;
• Outstanding communication skills;
• High degree of professional ethics and integrity
• Bachelor’s Degree from Accredited University
• Certification in Healthcare Compliance preferred or willingness to obtain
• Three years’ experience in health care compliance or similar experience preferred
• Juris Doctorate of Law, preferred (but not necessary)

Performance Requirements:

Knowledge:

• Knowledge of government compliance regulations including but not limited to HIPAA, MIPS/MACRA, ACO Participation, The Office of Inspector General’s (OIG) compliance guidance for individual and small group physician practices.
• Knowledge of federal fraud and abuse laws.
• Knowledge of key healthcare fraud and abuse laws including the False Claims Act, Stark Laws, and Anti-kickback Statute, including the associated penalties.
• Knowledge of writing procedures and policies.
• Knowledge of electronic medical record charting is preferred.

Ability to:

• Accept direction from leadership and act promptly.
• Strong analytical skills.
• Show skills in listening perceptively, conveying awareness and responding to physician/staff questions.
• Maintain composure in the face of resistance, indifference and opposition.
• Maintain confidentiality and to work with sensitive and confidential information using discretion and judgment.
• Working knowledge of the medical office systems.
• Excellent communication and writing skills required.
• Familiarity with basic computer functions is necessary.
• Strong problem-solving and decision-making skills required.

Organizational Structure:

• This position reports to: CEO
• Job Titles directly reporting to this position: None
• Working Conditions: Temperature controlled office setting (work from home possible)
• Physical surroundings: Medical office
• Adverse working environment: Work may be stressful due to continual interaction with others, long hours required and nature of the medical specialty.
• Physical Effort: Must possess the physical and mental abilities to perform the tasks normally associated with a pharmacy role including walking, bending, standing, reaching and sitting.
• Domestic/International Travel: possible but unlikely, may include travel within the state to visit outreach clinics
• Extensive Hours: Varies depending on need

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this position. They are not intended to be an exhaustive list of all associated responsibilities, skills, efforts or working conditions. Mission Cancer + Blood reserves the right to change, amend, add, delete and otherwise assign any and all duties, responsibilities and position titles as it deems necessary to meet the needs of the business.

Job Type: Full-time

Pay: From $80,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Education:

• Bachelor's (Preferred)

Work Location: One location

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