Compliance Specialist

Job Description

Last Revised & Approved

Version #

Job Title : Governance and Compliance Specialist (GCS) FLSA Status : Non-exempt

Reports To : Compliance Manager Union Position : Non-Union

Approved

By : Chief HR, Legal and

Compliance Officer (CHLCO) Department : Compliance

Approved

Date : 10 / 24 / 24

Jobs

Supervised : No

OUR MISSION is to eliminate health disparities and foster community well-being by providing and

promoting the highest quality care in Los Angeles, San Bernardino, and Riverside Counties.

OUR VISION : St. John‘s Community Health will be a leader, catalyst, and model for the best care,

long-term community health improvements, and sustainable, health-enhancing system and

structures in Southern California.

OUR CORE VALUES

Dignity

We honor and respect every person we encounter as a valued member of the human family

whose gifts and rights are to be protected.

Excellence

We support and champion individual and organizational growth, accountability, creativity,

teamwork, and commitment to quality, and the best standard of care.

Well-Being

We promote and advocate for the full integration of our patient‘s physical and mental health with

their needs as an active member of a vibrant and just community.

Social Justice

We collaborate with others to develop systems, organizations, and programs that address the

needs of and empower all members of our community with a preference for the most vulnerable

and disadvantaged.

JOB SUMMARY

As the Governance and Compliance Specialist at St. John‘s Community Health (SJCH), you are

responsible for ensuring that SJCH‘s policies and procedures comply with regulatory

requirements and industry best practices. You will work with other departments, such as legal,

IT, and audit, to develop and implement strategies to mitigate risk and maintain compliance.

Additionally, you will provide analysis, post-award services, and oversight to ensure compliance

with grant-specific requirements; and serve as a resource for staff of grant-funded programs for

fiscal and programmatic compliance matters. Works collaboratively to ensure staff are in

compliance with the rules and regulations of regulatory agencies; that company policies and

procedures are being followed, and that behavior in the organization meets the company‘s

Standards of Conduct. The Governance and Compliance Specialist will also play a key role in

supporting the privacy compliance functions.

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ESSENTIAL DUTIES AND RESPONSIBILITIES

Performs a combination, but not necessarily all, of the following duties :

• Monitor and interpret federal, state, and local healthcare laws. This includes regulations

related to patient privacy (HIPAA), billing and coding (CMS regulations), fraud and abuse

laws, etc.

Plans.

to ensure fiscal responsibility.

operations, and clinical teams to promote a culture of compliance.

relates initiatives.

participating in privacy projects and audits.

policies, and processes needed to identify and manage the revenue and expenditures of

the organization and its various components.

implementation and ongoing efforts to ensure compliance.

categories such as salaries, percent of effort, salary adjustment increases, fringe

benefits, indirect costs, materials, and equipment.

contractors / subrecipients according to the federal procurement and internal processes.

documented.

continuing basis, taking appropriate steps to improve its effectiveness.

inquiries.

HRSA), Federal Tort Claims Act (FTCA), Operational Site Visit (OSV) and any third-

party audits.

remain abreast of the status of all compliance activities and to identify trends.

action plans for resolution of problematic issues, and provides general guidance on how

to avoid or deal with similar situations in the future.

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information.

Responsibility to Team :

Actively support assigned team / department by participating in and supporting all

team / departmental initiatives, proactively communicating with supervision, meeting assigned

goals and objectives, and committing to embracing process improvement initiatives.

Responsibility to Organization :

Actively support SJCH by consistently meeting St. John‘s Mission, Vision, and Values; modeling

positive interactions with patients, staff, and community; keeping informed of internal (e.g.,

policies and procedures) and external (e.g., legal or political matters) which may affect business.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty

satisfactorily. The requirements listed below are representative of the education, experience,

knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable

individuals with disabilities to perform the essential functions.

Education, Experience, Knowledge, & Experience

organization.

pressure.

Additional Requirements : Employees are responsible for maintaining individual certifications as

required by job function or by law and provide verification and recertification when requested by

management :

needed.

Language Skills

Ability to read, analyze and interpret general business periodicals, professional journals, technical

procedures, or governmental regulations in English. Ability to write reports, business

correspondence, and procedure manuals in English. Ability to effectively present information and

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respond to questions from groups of managers, clients, customers, and the general public.

Bilingual English / Spanish (read, write, speak) preferred, not required.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions. Synthesize

complex or diverse information. Ability to interpret an extensive variety of technical instructions in

mathematical or diagram form and deal with several abstract and concrete variables. Ability to

interpret situations, characteristics, behavior, etc. and respond appropriately.

Computer Skills

To perform this job successfully, an individual should have strong knowledge of MS Office Suite,

Database Management, Email Communication, Internet Research, Social Media Management,

Event Management Software, Project Management Software, Teleconferencing and Virtual

Meetings, Document Collaboration Platforms, Data Analysis Tools, CRM Systems, and Online

Survey Tools.

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 regularly required to sit; use hands to

finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally

required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift

and / or move up to 40 pounds. Specific vision abilities required by this job include close vision,

distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT

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.

While performing the duties of this Job, the employee establishes and maintains effective work

relationships with co-workers and customers, maintains regular attendance, understands and

carries out a variety of oral and written instructions, has knowledge of proper English usage,

grammar, punctuation, spelling, and vocabulary, has the ability to learn office principles, practices,

and methods, understands filing systems, including numerical, alphabetical, and chronological,

learns a variety of procedures, policies, and services of the assigned work unit or program,

performs assigned duties with efficiency and accuracy and maintains confidentiality.

The employee will be working in a normal office environment with exposure to moderate noise,

dust, temperature, etc. During community meetings and outreach activities an employee may be

subjected to a variety of locations and situations including community centers and large meeting

rooms; this may involve varying noise levels, temperature, dust, or other environmental

differences.

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NOTE

The statements herein are intended to describe the general nature and level of work performed

by employees, but is not a complete list of responsibilities, duties, and skills required of personnel

so classified. It is not to be constructed as an exhaustive statement for essential functions,

responsibilities, or requirements. Furthermore, they do not establish a contract for employment

and are subject to change at the discretion of the employer.

I understand the essential functions of this position and I am able to perform the functions of this

position with or without accommodation.

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