Manager - Audit & Compliance

JOB PURPOSE & MISSION  

Responsible for the day-to-day management, operation and accountability for the Audit & Compliance area. Makes decisions, within guidelines, that could seriously affect the division, department and/or GHS System’s financial and performance objectives and strategic results. Develops and monitors the budget for assigned area(s). Direct reports may include supervisors, and/or staff employees including responsibility for performance reviews, hiring, disciplinary actions and terminations. Performs duties for the age population served, as defined in the department’s scope of service.  

Essential Job Functions include, but are not limited to:   

1. Ensures that objectives of the department or area of responsibility are administered.  

Ensures that established priorities for department are carried out on a daily basis.  

Ensures that goals and objectives of the department are consistent with the GHS’s philosophy.  

Ensures that departmental measures for processes and expectations are carried out on a daily basis.  

Uses alternative methods of providing services to reduce department-operating costs.  

Coordinates staffing needs of the department with regards to market/seasonal changes.  

2. Maintains an organized department to ensure efficiency, accuracy of work, and information flow.  

Monitors department operations and recommends changes as needed.  

Ensures the efficient operation of the department.  

Utilizes available staff to maximize the effectiveness of the work performed.  

Reviews the compilation and analysis of department data as necessary.  

3. Demonstrates effectiveness in directing the activities of the department.  

Ensures staff members adhere to policies and procedures necessary to achieve department objectives.  

Establishes and maintains an effective working relationship with management and other departments.  

Maintains an effective performance improvement program.  

Manages supervisory and department staff members.  

4. Demonstrates effectiveness in controlling the daily activities of the department.  

Reviews the daily productivity of the department.  

Provides management and policy interpretation to supervisors.  

Communicates effectively and expresses information clearly.  

Encourages staff participation and communication in decision-making.  

Exhibits responsiveness to others in the organization at all levels.  

5. Plans operational audits performed by the department, in conjunction with Audit Plan and with approval from Director.  

Prepares audit programs by determining audit procedures to be used.  

Conducts or assists in performing various audit assignments or special audit projects.  

Prepares oral and written reports as requested on the results of assigned audits or audit projects.  

Assists in conducting preliminary audit surveys.  

6. Tests, verifies and analyzes data using established audit standards, procedures and techniques.  

Reviews transactions, documents, records and operational methods to determine adequacy of control and efficiency of operation.  

Prepares and organizes supporting documentation.  

7. Monitors projects in progress for adherence to project objectives.  

Verifies that project deadlines and schedules are being met.  

Keeps supervisor informed of project progress.  

8. Conducts discussions of apparent deficiencies with operating personnel to verify facts and obtain explanations for the deficiencies.  

Identifies deficiencies in controls.  

Recommends corrective actions to strengthen controls, improve operations and reduce costs as appropriate.  

9. Performs all other duties as assigned.  

Performs HIPAA duties in absence of Privacy Officer and/or Director of Revenue Cycles.  

Performs special projects requested by management.  

HIPAA & SAFETY REQUIREMENTS  

HIPAA - Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: Medical records without limitation both paper and electronic, patient demographics, lab and radiology results, patient information related to surgery or appointment schedules, medical records related to quality data, patient financial information, patient billing, 3rd party billing information, research information, employee prescriptions, information related to patient location, religious beliefs and/or public health records.  

SAFETY - Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: Incident reporting, handling of wastes, PPE, exposure control plans, hand washing, environment of care, and patient identification.  

PERFORMANCE CRITERIA & STANDARDS  

Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.    

Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.   

Takes initiative in living our Everyday Excellence values and vital signs.   

Takes initiative in identifying customer needs before the customer asks.   

Participates in teamwork willingly and with enthusiasm.   

Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.   

Keeps customers informed, answers customer questions and anticipates information needs of customers   

Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines and the GHS Corporate Compliance Guidelines.   

Practices diligence in fulfilling the regulatory and legal requirements of the position and department.   

Maintains accurate and reliable patient/organizational records.   

Maintains professional relationships with appropriate officials; communicates honestly and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.   

Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.   

Sets goals and action plans to achieve objectives.  

Completes assignments following accepted procedures and practices, even when workloads and demands are high.  

Adheres to high moral principles of honesty, loyalty, sincerity, and fairness (integrity).  

Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.   

Strives to continuously improve all aspects of the business operation through quality improvement initiatives.  

Assures the accuracy of data, work, or information and contributes ideas and suggestions to improve approaches, methodologies, and productivity.  

Willingly participates in organization and/or department quality initiatives.  

Cost Management - Employee demonstrates effective cost management practices.   

Demonstrates effective time management to promote productivity and cost efficiency.  

Uses material goods wisely, is conscious of the environment and is accountable for prudent use of our talents and financial resources.  

Develops appropriate budget(s) for areas of responsibility.  

Effectively manages budget(s) and continually monitors key cost areas.  

Leadership – Employee demonstrates effective leadership by developing standards of performance, determining areas of responsibility and accountability and delegating authority.  

Invites input from others and shares ownership and recognition.  

Inspires people by example and influences them to do and be their best.  

Inspires and encourages teamwork.  

Consistently executes applicable company policies, rules and regulations.  

Operations Management – Employee demonstrates the ability to give clear and concise instructions as to assignment objectives and methods, and reviews results at all critical points.  

Establishes clear work objectives that prioritize and focus employee efforts.  

Staffs work area with appropriate numbers of qualified employees.  

Allocates and delegates work effectively to make efficient use of resources and employee capabilities.  

Performance Management – Employee demonstrates an awareness of employees’ development needs to improve work effectiveness, and insures that training and related programs are available to meet these needs.  

Provides opportunity for skill development for employees.  

Provides ongoing performance feedback to employees and takes corrective action when necessary.  

Completes and conducts performance appraisals by established review date.  

Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.   

Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.   

Employee proactively reports errors, potential errors, injuries or potential injuries.   

Employee demonstrates departmental specific patient and employee safety standards at all times.   

Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.   JOB REQUIREMENTS   

Experience  

Required: 5 years combined auditing experience  

Preferred: 2 or more years within the healthcare industry preferred   

Education  

Required: Bachelor’s Degree in accounting or other field supporting the practice of internal auditing  

Certifications & Licensure  

Requi red: CPA or CIA certification  

Preferred: CHC certification  

Special Skills or Knowledge  

Required: none  

Preferred:  

General knowledge of accounting principles and practices.  

Basic understanding of automated systems and audit procedures and techniques.  

Basic knowledge of computer operations.  

Proficiency in analysis software (e.g., IDEA, ACL). Familiarity with healthcare laws and regulations.  

Full-Time