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Organizational Integrity Specialist - Remote

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Job ID: 40521
Location: Vancouver, WA
Work Type: Full Time
Shift: Day
Shift Length: 8 Hours
FTE: 1.00
Benefit Eligibility: Full-time benefits

Job Description

Description

PeaceHealth is seeking a Organizational Integrity Specialist 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 is remote, however the selected caregiver must reside in OR, WA, AK or TX. 

JOB SUMMARY

Responsible for the collaborative development, coordination, and delivery of the Organizational Integrity (OI), Conflict of Interest (COI), Business Courtesies, Gifts, Downstream Entity and Payor Attestation Program and Exclusions monitoring program (referred to as “the program”) to drive a culture of compliance throughout the organization. Assists caregivers in complying with the ethical and legal requirements to avoid violations of COI, Business Courtesies, gifts, and exclusions issues; and to ensure all investigations have been sufficiently analyzed and resolved. Supports the program activities and initiatives including reporting, communications, training, and projects. Facilitates the development of data-related systems including data management, tracking of information, and technical solutions including working with vendors to fulfill the obligations of the program. Serves as a member, lead or liaison for multi-disciplinary teams, committees, and groups.

ESSENTIAL FUNCTIONS

  • Coordinates the OI Conflicts of Interest (COI), Gifts, Attestation program and Exclusions program including investigations, audits, and monitoring requests for compliance. Participates in the annual risk assessment process.
  • Administers the annual COI caregiver recertification process and ensures timely completion by new hires, volunteers, temps, and contractors. Analyzes audit reports and provides updates, concerns, and recommendations to leadership. Conducts investigations and audits related to COI compliance concerns and develops action plans to address situations.
  • Coordinates PeaceHealth’s Gifts policy to ensure receipt of gifts by caregivers on behalf of themselves or the organization are within guidelines and compliant with the Sunshine Act and all required reporting functions. Conducts investigations and audits related to gift policy compliance concerns and develops action plans to address situations.
  • Coordinates PeaceHealth’s Business courtesy program to ensure courtesies given to external groups on behalf of PeaceHealth are within guidelines and compliant with regulations with the Stark and Anti-Kickback statute and all required reporting functions.
  • Administers the screening of excluded/debarred persons according to federal and state requirements. Investigates report results to ensure compliance with federal and state laws and regulations and identifies and develops operational action plans to ensure compliant resolution.
  • Develops and maintains the PeaceHealth list of all Downstream Entities, provides oversight of Downstream entities performance and identifies those that may require a corrective action plan and ensures downstream agreements include the downstream addenda by collaborating with internal departments and helping to facilitate any training necessary.
  • Coordinates and facilitates compliance attestations required by payers. Partners with relevant departments within PeaceHealth and external payers to complete attestation and all necessary required documents.
  • Develops, delivers, and participates in the OI Conflict of Interest, Gifts, and Exclusions program training and education to ensure is well publicized and understood throughout the organization. Monitors, tracks, and implements changes with applicable laws and regulations impacting the program. Supports compliance with the program including working with internal clients and external entities.
  • Develops and updates the program to maintain its integrity and relevance including adjustments to relevant policies and procedures. Implements assessment tools, surveys, and other metrics to evaluate the impact and effectiveness of the program. Periodically performs a gap analysis including benchmarking.
  • Collaborates with other departments to gather reporting information and data as needed to ensure program objectives are achieved.
  • Performs other duties as assigned.

QUALIFICATIONS

EDUCATION:

  • Bachelor’s degree or equivalent knowledge and skills obtained through a combination of education, training and experience required.

EXPERIENCE/TRAINING:

  • Minimum of four years of general compliance experience required.
  • Previous experience in healthcare preferred.

LICENSE/CERTIFICATION

  • Certified Healthcare Compliance (CHC) required. Must obtain within 24 months from date of hire if not obtained at time of hire.

OTHER SKILLS:

  • Ability to lead programs and work independently while achieving objectives.
  • Outstanding attention to detail.
  • Exceptional written and verbal communications skills.
  • Ability to work with people of diverse functional specialties, backgrounds and levels, responding to their needs through collaboration and use of effective group dynamics.
  • Leadership ability and skills, good judgment and a cost-effective approach to work management.
  • Strong facilitation, team building and interpersonal skills.
  • Strong customer service orientation with focus on treating all persons with respect and dignity.
  • Excellent organizational skills, ability to prioritize work effectively.
  • Experience using a variety of software and information technologies (i.e., MSWord, PowerPoint, Excel, and Outlook).

PHYSICAL/COGNITIVE REQUIREMENTS

  • Work requires fairly light physical exertion from up to 65% of the time.
  • Ability to lift objects weighing 30 lbs. or less.
  • Work is performed under normal working conditions with adequate lighting and ventilation.
  • Job duties frequently require intense concentration and attention to detail (up to 65% of work time).

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.

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