Ethics Specialist jobs in Nevada

New Pay Grade for 2024! 

Hourly Range: $62.34 USD to $99.72 USD

Summary of Position:
The Compliance and Ethics Officer is responsible for overseeing the administration and implementation of the corporate compliance plan, conflict of interest policies and coordination of HIPAA privacy/security compliance programs throughout Barton Health. This position will be responsible for the implementation and maintenance of compliance policies throughout Barton Health. This position supports the organization’s mission, vision, and values through activities to ensure compliance across the system. Acts as a resource for the organization regarding regulatory standards and identifies strategic initiatives to support the organization’s goals.
This position assists in the identification, implementation and maintenance of Barton Health’s information privacy policies and procedures in coordination with his/her immediate Director, the HIPAA Privacy Officer, the HIPAA Security Officer, Corporate Counsel and related committees.
Responsible for performing and/or coordinating ongoing compliance monitoring activities, to include but not limited to, timely reporting of required data to state and Federal agencies.
Assists Corporate Counsel in management, organization, and coordination of compliance and legal issues facing Barton Health. This position also coordinates with Corporate Counsel, human resources, and outside counsel on tracking and organization of labor and employment issues.

Qualifications
Education:
• Bachelor’s degree required in Business, Healthcare Administration, or related field.
• Juris Doctorate with health care focus is strongly preferred, an advanced degree (MS/MBA/MHA) or substantial compliance experience in lieu of a JD will be considered.
Experience:
• Three years of experience in related healthcare compliance required.
• Seven years of successful management experience in the field of healthcare compliance preferred with an emphasis on privacy and security frameworks.
• Experience with EPIC Electronic Health Record or similar electronic record systems.
• Experience with conducting confidential compliance investigations.
• Experience with compliance risk assessments and compliance reviews.
• Experience with conflicts of interests reporting and monitoring.
• Experience with review and analysis of labor, employment, and human resources matters.
Knowledge/Skills/Abilities:
• Expert knowledge of corporate compliance in a healthcare environment.
• Expert knowledge of the OIG guidelines, compliance program elements and frameworks.
• Working knowledge of hospital operations and knowledge of the local, state, and national environment of health care.
• Ability to develop compliance analysis and reporting programs.
• Working knowledge of conducting and managing investigations.
• Ability to provide concise and understandable guidance and reports on compliance issues.
• Expert knowledge of HIPAA Information Security and Privacy control monitoring
• Expert knowledge of healthcare compliance laws and regulations including, but not limited to, HIPAA, False Claims Act, Civil Monetary Penalties Act, EMTALA, referral laws (e.g. Stark and Anti-Kickback Statute) and the requirements to participate in federal healthcare programs.
• Highly effective collaboration skills, written and verbal communications skills.
• Ability to implement corporate compliance oversight initiatives.
• Ability to develop relationships with the various departments to establish a consistent and supportive process throughout the organization.
• Ability to diagnose problems and coach on related issues.
• Attention to detail, meticulous development, and maintenance of regulatory paperwork.
• Ability to review and either respond to or assign to the appropriate internal or external resource questions regarding healthcare billing.
• Ability to participate in and support negotiations and/or substantive discussions to resolve pending matters or disputes.
Certifications/Licensure:
• Certified in Healthcare Compliance (CHC) or in Healthcare Privacy Compliance (CHPC) preferred.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee is frequently required to walk, stand, sit, and talk or hear.
• The employee is occasionally required to use hands to finger, handle, feel or operate objects, tools, or controls; and reach with hands and arms.
• The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl.
• Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
• The employee must occasionally lift and/or move up to 25 pounds.
Working Conditions
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Normal office environment. The noise level in the work environment is usually quiet to moderate while in the office.
• Occasional travel to various health system locations, including, but not limited to, travel for onsite inspections, interviews, proceedings, and investigations.
• Subject to varying and unpredictable situations, including the handling of emergency or crisis situations.
• Subject to pressure due to irregular hours, frequent interruptions and stressful situations due to multiple demands.
Essential Functions
1. Provide consistently exceptional care at all times.
2. Manages compliance program to meet all state and federal mandates.
3. Serves in the advisory, guidance and investigative role for HIPAA Security and Privacy compliance encompassing HIPAA, patient privacy, IS and Cybersecurity divisions. Collaborates closely with the Director of IS and HIPAA Security Officer to make recommendations for changes to technical security infrastructure and processes to support regulatory compliance. Collaborates closely with the HIPAA Privacy Officer on policies, standards, audits and investigations to manage compliance with HIPAA privacy standards.
4. Acts as corporate compliance officer, assuring administration and implementation of the corporate compliance program, as described in the Corporate Compliance Plan.
5. Advises and updates the Compliance Oversight Committee and serves as a member of the Revenue, Audit and Compliance Committee (“RAC”).
6. Oversees the development, review, update, and revision, as necessary, of the core organizing documents of the compliance program.
7. Develops and oversees implementation of an annual Compliance Work Plan with input from department heads and presents it to the Compliance Oversight Committee.
8. Establishes and oversees a regular training process about the compliance program for employees, independent contractors, volunteers, physicians and affiliated professionals through training programs, newsletters, memoranda, and other means, as well as assures the development of department-specific or subject-specific training on regulatory requirements related to department functions and documents the regularity and consistency of such training.
9. Coordinates with personnel management to ensure that Barton does not employ or contract with any individual who has been convicted of a criminal offense related to health care within the previous five years, or who is listed by a federal or state agency as debarred, excluded, or otherwise ineligible for participation in any federal or state health care program.
10. Works with department heads to develop standards of conduct and policies and procedures to promote compliance within each department.
11. Oversees and manages conflict of interest and other corporate ethics policies and processes in coordination with the Corporate Counsel, including managing and maintaining the conflict of interest reporting program.
12. Creates and maintains the ethics culture at Barton.
13. Engages in technical internal auditing and monitoring of information security systems, processes, and controls.
14. Recommends and monitors the development of internal systems and controls to carry out standards, policies, and procedures as part of daily operations, in coordination with department heads.
15. Implements and oversees compliance auditing and review processes.
16. Implements and oversees the development of confidential systems for employees and others to seek guidance on business conduct and to report suspected violations of law or Barton compliance standards, or other policies and procedures.
17. Investigates suspected violations of compliance policies (conferring with legal counsel where appropriate) including investigation of overpayments.
18. Works with the Chief Financial Officer regarding regular financial audits by outside auditors.
19. Conducts a regular review of the compliance program’s functioning and prepares periodic and annual reports for the Governing Board describing the compliance efforts undertaken during the preceding period or year, as appropriate, and identifying any changes necessary to improve the compliance program.
20. Review all documents and other information relevant to compliance activities, including, but not limited to, patient records, billing records, marketing efforts, and arrangements with third parties.
21. Performs a variety of tasks related to corporate compliance as designated by the Corporate Counsel for Regulatory Compliance and Risk or the Chief Executive Officer.
22. Provides feedback and support to human resources, Corporate Counsel, and outside counsel on human resources matters.
23. Actively participates in and supports negotiations and/or substantive discussions to resolve pending matters or disputes
24. Responds to the needs of the department by performing other duties, as necessary.