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Compliance Officer - Remote local to CA preferred
Compliance Officer - Remote local to CA preferred The Compliance Officer responsible for implementing the Surgery Partners Compliance Program for affiliated Facilities within a defined region of Surgery Partners. Responsible for training and monitoring compliance with regulatory compliance requirements by all employees, staff, vendors and others performing services at assigned facilities. Position will be remote based with periodic travel to Surgery Partners headquarters in Brentwood, TN and as needed to facilities within assigned west region. Duties include, but are not limited to the following: • Developing and implementing policies, procedures, and practices designed to ensure compliance with the requirements • Making periodic (at least quarterly) reports regarding compliance matters to the SVP, Chief Compliance Officer of Surgery Partners • Monitoring the day-to-day compliance activities engaged in by Affiliate Facilities In addition, the Compliance Officer helps implement the eight elements of the Surgery Partners Compliance Program at Facilities. Duties include development and delivery of compliance training, revision of policies and procedures as needed, and provide and assist with monitoring, auditing, investigating issues, and reporting on the effectiveness of Surgery Partners Compliance Program at Facilities. The Compliance Officer will provide timely advice to Facilities operational leadership and others as needed. Promote Compliance to Organization • Participate in the implementation of the Surgery Partners Compliance and Ethics Program at Facilities. • Responsible for assisting in the planning, design, implementation and monitoring of the compliance program. • Demonstrates understanding of and promote adherence to the Surgery Partners Code of Conduct, the Surgery Partners Compliance and Ethics Program and all laws, regulations, and company policies governing the delivery of quality health care services. • Understands regulatory laws and guidelines, and partners with local management and regional leaders to provide continual risk assessment, development of comprehensive policies and procedures, compliance training, protocols, internal investigations, providing regulatory reviews & opinions and auditing and monitoring. • Serves as a contact person for reports of concerns or potential compliance issues. Confers with management staff to identify and correct potential areas of noncompliance and anticipate future compliance requirements. Brings all reported issues to the attention of the Chief Compliance Officer. • Coordinates the development, maintenance, implementation, and revision of policies, process and procedures and other documents for the operation of the compliance program. • Work with Legal, Operations and other functions to assure awareness of regulatory compliance requirements applicable to Facilities provision of healthcare and related services; review and make recommendations with respect to the Facilities policies and processes related to such compliance requirements (e.g., state and local law licensing requirements). Monitoring • Possess a clear understanding of healthcare law and revenue cycle management and the ability to conduct advanced research. • Develop and implement investigation procedures to ensure adequate and timely follow-up to all Facilities Compliance Hotline (Surgery Partners Action Line) reports and all other reports of potential compliance violations received through other channels. • Develop an audit plan to verify compliance with Facilities’ Compliance Policies and Procedures by all employees, at all worksites. • Review results of excluded person monitoring for all new employees or independent contractors in conjunction with Human Resources and coordinate responses to identified person who may be a match to an excluded person at the Federal or State level. • In consultation with Human Resources, participate in the implementation of and promote the usage of disciplinary guidelines regarding the actions to be taken for violations of the Compliance Policy and Procedures. • Monitor the day to day compliance activities of Facilities. Analyze statistical data and reports to identify and determine compliance issues. • Performs compliance audits for the purpose of monitoring processes and detecting noncompliance, including coordinating audit activities and responses. Prepares audit reports and makes recommendations to the Surgery Partners Chief Compliance Officer, Facilities CEO and local management based on findings. Prepares periodic reports for management and the Compliance Committee of Facilities. • Reviews and updates Facilities Compliance Policies, contracts and other compliance related materials to ensure they are current and relevant with all applicable federal, state, and industry laws, regulations, and standards in providing guidance to management and employees. Compliance Education • Provide consultation and education for Facilities staff impacted by compliance activities. • Assist in the development and provision of compliance training to employees, medical staff, and independent consultants. • Compile training reports to monitor adherence to training requirements. • Performs research and analysis on Corporate and federal payer rules, regulations and transmittals and communicates requirements to operational areas. Issue Tracking • Participates in Compliance Operations Meetings and assists with the tracking and resolution of compliance issues that affect operations. • Maintain logs of inquiries and track research and disposition of compliance issues raised by senior management, employees, business partners and external auditors. Collaboration / Leadership • Adhere to all company policies and procedures. Practices and adheres to the “Code of Conduct” and “Mission and Value Statement”. • Provide support to joint projects with other Compliance staff. • Collaborates with operational department managers to resolve compliance or regulatory concerns. • Communicate regularly with internal departments to ensure audit deliverables and remediation responses are submitted timely. • Acts as a resource for compliance, government and third-party reimbursement regulations and rules. • Provides advisory assistance regarding billing compliance matters. • Formulate, affect, interpret, and implement compliance policies and procedures as needed. Other • Assist the Chief Compliance Officer in risk analysis, planning, auditing and program development for compliance activities throughout Facilities • Formulate, affect, interpret, and implement compliance policies and procedures as needed. • Analyze compliance and internal process risks for all Facilities Operational areas. • Travel (local and national) may be required periodically with this position but is not expected to exceed 25% of time now or in the immediate future. (Facilities are in California, Alaska, Utah, Montana, Nevada) • Other duties as assigned. Basic Surgery Partners Performance Criteria • Demonstrates Surgery Partners and Code of Conduct as well as adheres to policies and procedures and safety guidelines. • Demonstrates ability to meet business needs of department with regular, reliable attendance. • Employee maintains current licenses and/or certifications required for the position. • Practices and reflects knowledge of HIPAA, TJC, AAAPC, OSHA and other federal/state regulatory agencies guiding healthcare. • Completes all annual education and competency requirements within the assigned timeframe. • Is knowledgeable of compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of administrative staff. Takes appropriate action on concerns reported by department staff related to compliance. EDUCATION/EXPERIENCE • Bachelor's Degree in Business Administration, Health Information Management, Health Administration or similar degree. Equivalent work experience may substitute education requirements. • Master’s in Accounting or Juris Doctor preferred but not required. • Minimum 5 years experience as a mid to senior level compliance professional in the healthcare industry. • Certification as a CHC • Licensed attorney with experience practicing law in law firm or in-house legal department preferred but not required. • Licensed CPA with experience in Revenue Cycle / Healthcare Business Office operations preferred but not required. Benefits: • Comprehensive health, dental, and vision insurance • Health Savings Account with an employer contribution • Life Insurance • PTO • 401(k) retirement plan with a company match and more! Equal Employment Opportunity & Work Force Diversity Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization. • If you are viewing this role on a job board such as Indeed.com or LinkedIn, please know that pay bands are auto assigned and may not reflect the true pay band within the organization. • No Recruiters Please Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. Apply tot his job Apply tot his job Apply tot his job Apply tot his job