Healthcare Compliance Consultant - Organizational Integrity (Remote)

Job Description

Description

PeaceHealth is seeking a Healthcare Compliance Consultant - Organizational Integrity for a Full Time, 1.00 FTE, Day position.

Must be fully vaccinated for COVID-19 including 2 doses of a 2-dose series or 1 dose of a 1-dose series plus 14 days beyond the final dose prior to start date.

This position can be performed fully remote. If telecommuting, PeaceHealth will provide the caregiver with necessary computer equipment. It is the responsibility of the caregiver to provide Internet access. Caregiver must reside in OR, WA, AK or TX.

JOB SUMMARY

Assists the Manager, Healthcare Compliance in developing and maintaining the Healthcare Compliance Program for PeaceHealth. Manages process-related compliance investigations; proactive annual work plan audits; and monitoring related compliance across the system and/or by assigned network or operational specialty area. Responsible for identifying, assessing, and recommending corrective actions (including analyzing root causes and controls) regarding process-related issues to help support operational compliance with state and federal laws and rules.

Contributes to the development and maintenance of a compliance program in accordance with the Department of Health and Human Services, Office of Inspector General (OIG), state and local regulations. Implements and maintains an effective compliance program based upon the seven (7) elements promulgated by the OIG.

ESSENTIAL FUNCTIONS

1. Implements the PeaceHealth Healthcare Compliance (HCC) Program for system, assigned network and/or operational specialty area(s) including the development, communication, implementation, monitoring, and maintenance of the program by partnering with all levels of caregivers on process-related compliance initiatives.
2. 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.
3. 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.
4. 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.
5. 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 area(s).
6. Provides guidance to operational leaders and acts as a trusted advisor for controls recommendations and root cause evaluations related to corrective action plans.
7. Conducts proactive monitoring encompassing key operational compliance activities to evaluate the long-term efficacy of compliance-related controls.
8. Participates in and/or manages the department’s annual risk assessment resulting in the Healthcare Compliance Annual Audit Work Plan including participating in quarterly updates as appropriate.
9. Acts as a consultant to operational leaders responsible for developing, documenting, updating, and maintaining departmental-specific compliance programs as needed.
10. 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).
11. Participates on committees, task forces, projects, and in various meetings.
12. Performs other duties as assigned.

QUALIFICATIONS

EDUCATION:

• Bachelor’s degree in healthcare administration or equivalent discipline is required. Master’s degree preferred.

EXPERIENCE/TRAINING:

• Minimum of seven (7) years of relevant healthcare or other applicable compliance experience and/or clinical operations experience required.
• Experience with the 7-elements of a compliance program preferred.
• Medical records experience preferred.

LICENSE/CERTIFICATION:

• Certified Healthcare Compliance (CHC) or obtained within 18 months from hire.

OTHER SKILLS:

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

At PeaceHealth, we carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way. The fulfillment of this Mission is our shared purpose. It drives all that we are and all that we do. Caregivers of PeaceHealth embrace the spirit of these words and share our commitment to Exceptional Medicine and Compassionate Care and are willing to learn and grow as a member of the PeaceHealth family.

DISCLAIMER:

The above information on this description has been designed to indicate the general nature and level of work performed within this job class. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of caregivers assigned to this job.