Healthcare Compliance Specialist

Description

The Healthcare Compliance Specialist at Southeast Primary Care Partners is a key figure in upholding the organization's commitment to compliance. This role involves setting the standard for compliance, educating staff, and offering guidance on compliance-related matters. The specialist works collaboratively across various departments to ensure the organization's compliance framework is robust and effective. Reporting directly to the SPCP Compliance Officer.

Requirements

Key Responsibilities:

• Coordinate and facilitate compliance meetings to ensure ongoing awareness and adherence to regulations.
• Undertake special projects and research to identify trends, analyze data, and evaluate the impact and efficiency of compliance initiatives.
• Collect and report data to monitor and evaluate the effectiveness of projects and programs.
• Review submissions related to healthcare professionals, medical institutions, and government officials to ensure alignment with organizational policies.
• Stay updated with US and state healthcare compliance laws, regulations, and enforcement environments.
• Provide guidance on the organization's compliance policies and programs, and educate staff on applicable rules, regulations, and best practices.
• Collaborate with departments such as Sales, Marketing, Finance, Legal, Regulatory, Medical Education, and Clinical to ensure a cohesive compliance strategy.
• Manage compliance matters and risks professionally.
• Prepare compliance presentations and reports, including incident and training metrics.
• Promote a zero-tolerance environment for fraud or non-compliance.
• Conduct regular reviews of policies, training, communications, and other compliance program components for continuous improvement.

Requirements:

• Associates degree in Healthcare, Business, Legal, Accounting, Finance, or a related field (Bachelor's degree preferred).
• In-depth knowledge of healthcare laws and regulations, and ethics in healthcare.
• Experience in Compliance, Legal, Internal Audit, Risk Management, or similar regulatory/investigatory roles in healthcare.
• Strong analytical skills for conducting complex and sensitive compliance and fraud investigations.
• Excellent interpersonal skills to effectively establish rapport and manage relationships.
• Paralegal certification and experience are preferred.
• Exceptional communication skills for educating and counseling on compliance issues.
• Proficiency in computer applications like Microsoft Word, Excel, and PowerPoint.
• Preferred certification by the Compliance Certification Board, such as Certified Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP).
• Outstanding organizational skills to handle multiple projects, meet deadlines, and execute plans within time frames.

Physical & Mental Requirements:

• Ability to lift up to 25 pounds.
• Ability to push or pull heavy objects using up to 25 pounds of force.
• Ability to sit and stand for extended periods of time.
• Ability to use fine motor skills to operate office equipment and/or machinery.
• Ability to properly drive and operate a company vehicle.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to use logical reasoning for simple and complex problem-solving.