Demo

Compliance Specialist

Employee Referral Program - Great People Know Great People
Newtown, PA Full Time
POSTED ON 3/23/2025
AVAILABLE BEFORE 5/23/2025

Could you be our next Compliance Specialist with Main Line Health?

Make an Impact! The Compliance Specialist is primarily responsible for conducting and reporting on compliance audits, monitoring activities, investigations, and departmental projects involving compliance and investigation activities within Main Line Health. Informed and aware of compliance-related issues, this role's primary function will be to detect, document, report, and recommend resolutions to prevent incidents of non-conformity with applicable federal and state laws and regulations, policies, procedures and/or technical requirements.

This is a line-level position responsible for the planning and conducting of compliance activities and compliance-related investigations. This position is responsible for assisting the Chief Compliance and Privacy Officer in addressing all aspects of compliance, such as: HIPAA, healthcare fraud, STARK, and AKS. Develops and performs routine monitoring of activities within MLH. Report results and any recommended corrective actions to improve functions when needed to the Chief Compliance and Privacy Officer.

The specialist will monitor the MLH ethics reporting hotline for incoming reports of alleged misconduct; monitor laws, regulatory requirements, policies, procedures, and best practices; and communicate any updates to the Chief Compliance and Privacy Officer and Compliance staff regularly. The specialist will participate in providing training to internal stakeholders to improve their understanding of related laws, policies, procedures, and potential risks.

Develop and Grow your Career! Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status.

Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care.

Position-Specific Benefits: You are eligible for up to 240 hours of paid time off per year. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free!

Position: Compliance Specialist
Shift: Hybrid - Day Shift, Monday - Friday

Experience:

     1.   Minimum of three (3) years of experience in compliance, audit, or related governance functions within healthcare required.

     2.    Demonstrated expertise in healthcare regulatory compliance, including fraud, waste, and abuse laws (FCA, AKS, Stark), federal and state privacy laws (HIPAA, HITECH), and other relevant regulations (No Surprises Act, EMTALA, Price Transparency) preferred.

     3.    Familiarity with CMS Conditions of Participation, coverage policies, and payment systems (IPPS, OPPS) preferred.

Education:

1. Bachelor’s degree required in public/business administration, human resources, psychology, legal studies, health care administration, political science, health sciences, behavioral/social science or a closely related field. 

2. Associate's degree from an accredited institution in public/business administration, human resources, psychology, legal studies, health care administration, political science, health sciences, behavioral/social science or a closely related field AND two (2) years of experience* in any of the following areas within the scope of privacy and compliance: researching, analyzing and interpreting government regulations; making recommendations for the development, implementation, and improvement of various policies, procedures, programs, and operations; evaluating/monitoring programs; and/or compliance related audits.

*The 2 years of experience used to qualify with an Associate's degree will be treated as a substitution for the Bachelor’s degree and will not count towards any of the Required Experience.

 

Additional Information

Salary : $76,440 - $118,414

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