Manager, Compliance

Job Details:

Job Summary:

The Network Manager of Compliance reports to the VP, Compliance in the implementation and evaluation of Westchester Medical Center Health Network Compliance Program by monitoring compliance with internal and external regulatory standards of the Network. This position will also be responsible for providing consultation, assisting with audits relating hospital policies and procedures, including the review of medical records, HIPAA, training and education, investigations, and support on compliance issues to Administrators, Physicians and all levels of WMC Health Network staff.

Responsibilities:

• Participates with leadership in the development and implementation of the Annual Corporate Compliance Work Plan based on an internal risk assessment and federal and state initiatives.
• Provides consultation and guidance to leadership on compliance issues.
• Prepares classes and materials and provides consultation and training to new house staff and employees; conducts annual mandatory training programs and periodic in-services for staff.
• Create and maintains current compliance and HIPAA policies, Compliance Manual and Code of Conduct documents recommending changes as indicated by new regulations.
• Maintains knowledge of current legislation and regulations regarding compliance issues and recommends policy adjustments as indicated.
• Investigates and responds to violations of compliance issues and collaborates with the VP, Compliance and senior management as appropriate for resolution.
• Maintains records of investigations, prepares trend analyses and provides reports for management and regulatory agencies.
• Assists in the supervision of investigational activities of federal, state and local enforcement authorities.
• Identifies high risk areas for review and assists the VP, Compliance to prepare the related remedial or audit plan.
• Participates with leadership in identifying and recommending risk areas for auditing and developing an annual compliance work plan.
• Works closely with the VP, Compliance for the Health Network on compliance related activities.
• Collaborates with other department staff in the implementation of corrective action plans and takes proactive measures to avoid and/ or resolve conflicts that may arise.
• Collaborates with Information Systems staff to maintain current systems and plans for existing system upgrades to enhance productivity and efficiency of the operating system relating to HIPAA Security.
• Manages the distribution of the WMC Health Network Conflict of Interest Questionnaires.

Experience:

A minimum of three to five years of experience in compliance or regulatory management in a large tertiary academic hospital or healthcare facility, required.

Education:

Bachelor’s degree required.

Licenses / Certifications:

Certified in Healthcare Compliance (CHC), preferred

Other:

Special Requirements: Knowledgeable in HIPAA, and Federal and State regulations for hospitals, &physician practices. Planning and conducting effective, confidential investigations.

About Us:

NorthEast Provider Solutions Inc.