What are the responsibilities and job description for the Healthcare Compliance Manager position at Wellvana Health?
Wellvana joins together independent physicians into a comprehensive management program comprised of a common set of quality goals measured across all insurance carriers, focusing on improved health outcomes and reducing the long-term cost of care.
Summary:
Wellvana is looking for a Healthcare Compliance Manager to develop a compliance program, policies, and procedures that are aligned with the organizations direction. This role will strategize with the leadership team to implement a compliance program across the organization as well as provide compliance expertise.
Responsibilities:
- Establishes and maintains an effective compliance program, compliance policies and procedures in accordance with federal/state regulatory requirements to prevent, detect and correct non-compliance and identify potential fraud, waste and abuse.
- Implement audit directives, conduct Privacy Impact Assessments (PIA), oversee internal audit operations, and provide leadership and direction in communicating and monitoring audit policies, procedures, practices, programs and processes.
- Serves as Primary Contact for CMS and other regulatory agencies, responsible for official responses regarding issues, complaints and enforcement actions. Responds to government investigations and queries as the principal point of contact.
- Identify risk proactively, direct audits and corrective actions, investigate reported non-compliance and Code of Conduct violations, and ensure non-compliance issues are promptly investigated and resolved.
- Provide education and training on the Code of Conduct, compliance, guidance, laws and regulations.
- Track contracts from inception to execution.
- Develop and maintain a digital contract database that will include original contracts, amendments, terms, correspondence, and payment schedules.
- Assist in the preparation of contract documents using standardized legal forms.
- Review documents pre-sign (when provided) to ensure correct Wellvana contracting entity, notice provisions, authorized signor, etc.
- Alert management of contract renewals, extensions, and terminations.
- Ensure signed contracts are dated and fully executed.
- Ensure all relevant documentation accompanies contracts.
- Prepare termination notices for contracts.
- Interact cooperatively with all departments within the Company and outside legal counsel.
Qualifications:
- Bachelor's degree in Business Administration or other related degree preferred.
- 5 years’ experience in a healthcare compliance role handling HIPAA and Privacy Security, healthcare plans, or a related field in the healthcare industry
- CHC or CHCP certification, preferred
- Exemplifies knowledge of healthcare compliance, contract law, accounting principles and finance.
- Proficient in MS Office applications and ability to learn department and job-specific software systems.
- Demonstrate organizational skills.
- Demonstrate effective verbal and written communication skills.
- Demonstrate analytical skills when problem-solving.
- Demonstrate high attention to detail and a high degree of accuracy
Job Type: Full-time
Pay: $90,000.00 - $110,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Supplemental Pay:
- Bonus pay
Experience:
- healthcare compliance management: 5 years (Preferred)
Work Location: One location