Compliance and Risk Manager

Lake Superior Community Health Center is currently seeking a Compliance and Risk Manager.

The Compliance and Risk Manager is responsible for planning and coordinating services related to health information, referrals, and related activities imperative to the functioning of the clinic. The position includes identifying and mitigating risk in the clinic, monitoring and measuring the prior authorization aspect of the revenue cycle, training of staff, and supervising the Health Information department. Works collaboratively with all clinic departments to create and implement workflows, guidelines and training relevant to compliance and risk.

Job Qualifications:

• Bachelor’s degree in Health Information or related field
• At least two years of management experience
• Experience in a medical office environment preferred
• Knowledge/experience of the prior authorization and medical referral processes
• Experience working with an Electronic Health Record
• Advanced computer skills, including all Microsoft Office applications
• Ability to deal effectively with a variety of people and work in a team environment
• Ability to juggle multiple tasks, set priorities and work under deadlines

Job Knowledge, Skills and Abilities:

• Excellent interpersonal and written communication skills
• Familiarity and competence with healthcare laws, regulations, and standards
• Well versed in HIPAA regulations, to include the Information Blocking Rule
• Knowledge of Health Information Systems

Licensure and Credentials:

• As appropriate per discipline

Functions and Responsibilities:
1.0 Coordinate the health information services department (HIS Clerks and Referral Coordinators)
1.1 Monitors health information management systems and sets standards for data quality
1.2 Develops, educates and trains staff on new and revised protocols related to job functions, including but not limited to: release of information, prior authorizations, referrals, HIPAA, Information Blocking, etc.
1.3 Oversees the referral process to ensure continuity of care
2.0 Responsible to oversee that prior approvals are being conducted and requirements met
2.1 Work in collaboration with leadership team to achieve organizational financial goals
3.0 Drive process improvements within the clinic
4.0 Responsible for daily supervision of staff
3.1 Responsible for day to day human resource management
3.2 Coordinates time off within the department so duties are covered
3.3 Performs employee performance evaluation, coaching and discipline
5.0 Coordinates activities related to the development, implementation, maintenance and adherence to privacy, information security and compliance
5.1 Revises release of information policies and procedures and works directly with those involved with release of information
5.2 Performs regular privacy, information security and compliance risk assessments to identify potential areas of vulnerability, making recommendations for correction
5.3 Reports non-compliance issues to the Director of Quality, Compliance and Risk
4.4 Maintains up to date knowledge of HIPAA and other federal, state regulatory agencies
6.0 Provide training and support to staff in areas of responsibility
7.0 Assist in special projects
8.0 Other duties as assigned

Job Type: Full-time

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Work Location: One location