Job Information
Spectrum Health Services Compliance Manager in Philadelphia, Pennsylvania
Job Descriptions:
Job Summary:
The Compliance Manager assists the Chief Compliance and Privacy Officer with the development of the seven (7) elements of an OIG/HHS effective Compliance program and the on-going management of the program. Develops tools to periodically assess compliance effectiveness at Spectrum Health Services.
The Compliance Manager will assist and support the compliance functions of the organization through:
Analysis of Internal Business Processes
Policy Development and Implementation
Risk Management Identification and Strategies
Employee Training
Cross-Functional Collaboration
The Compliance Manager will assist with monitoring progress and conducting confidential investigations of diverse scope into allegations of violation of law, Spectrum’s Code of Conduct, or company policies. This role has direct responsibility for conducting compliance investigations from the initial assessment of allegations to completing investigative summaries and reporting investigation outcomes.
Additionally, the Compliance Manager will be responsible for daily operational functions of the core elements of the organization's compliance functions and work with Chief Compliance and Privacy Officer on matters needing escalation and resolution. Compliance Manager will also assist with preparation for the (1) Compliance Employee Committee (2) Spectrum Board Quality Committee and (3) Spectrum Board Committee. The Compliance Manager will need to be able to interface cross-functionally across the organization.
Competencies:
Technical Skills Reporting and Analysis Process Oriented
Supervision Data Visualization Project Management
Delegation Detail Oriented
Problem Solving Team Building
Decision Making Knowledgeable of healthcare processes and business regulations
Communication-verbal
Essential Functions:
Compliance Oversight
Assist with the development and maintenance of a robust corporate compliance program for Spectrum that mirrors the 7 elements of an effective corporate compliance program.
Manage and support Spectrum’s compliance with Federal laws (FWA, OSHA, HIPAA, HITECH etc.), HRSA Health Center Program regulations and Spectrum payors.
Serve on committees, and work groups, representing the Compliance Department.
Policies and Procedures
Develop and maintain all compliance policies associated with accreditations.
Serve as a resource for other departments for developing compliant operational processes.
Implement compliance programs, policies and procedures designed to ensure compliance with all applicable federal laws, regulations and delegation requirements.
Compliance Education and Training
Support the compliance training programs on a day-to-day basis, ensuring timely completion of on-boarding and topic specific training and education by the workforce.
Assist with creating and overseeing educational materials.
Provide compliance educational and training offerings
Lines of Communication
Respond to hotline calls and incident reports relevant to Spectrum business operations.
Audit and Monitoring
Perform tasks related to external audits from contracted health plans, local and federal entities.
Conduct standard random audits and focused audits to determine compliance to departmental standards.
Identify and assess risks within the organization and develop strategies to mitigate these risks; work with various departments to implement risk mitigation strategies and monitor their effectiveness.
Enforce Standards
Assist with communicating and publicizing consequences of non-compliance
Investigations and Corrective Actions
Investigate all compliance concerns and coordinates follow up with a corrective action plan as needed.
Perform related duties as required
General Information
Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
Communicates clearly and effectively to other employees and vendors, payors and patients.
Develops constructive and cooperative working relationships with others and maintains them over time.
Encourages and builds mutual trust, respect, and cooperation among team members.
Exemplifies the Spectrum’s mission, vision and values and acts in accordance with Spectrum’s policies and procedures.
Required Experience:
Qualifications/Experience:
Bachelor’s degree in business administration, Healthcare Administration, or related field or 3+ year experience in Healthcare or regulatory fields
Strong knowledge of industry processes and regulations.
Previous work in healthcare industry.
Outstanding communication and interpersonal abilities
Some regional travel required; infrequent national travel possible
Keyword: Compliance Manager
From: Spectrum Health Services, Inc