What are the responsibilities and job description for the Compliance Specialist position at St Johns Community Health?
As the 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 Compliance Specialist will also play a key role in supporting the privacy compliance functions.
Benefits:
- Free Medical, Dental & Vision
- 13 Paid Holidays PTO
- 403 (B) retirement match
- Life Insurance, EAP
- Tuition Reimbursement
- Flexible Spending Account
- Continued workforce development & training
- Succession plans & growth within
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 knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education, Experience, and Knowledge
- 3-5 years’ experience in regulatory compliance in a healthcare organization
- Strong interpersonal skills with a proven ability to work well with individuals at all levels of an organization.
- Excellent oral and written communication skills.
- Strong attention to detail.
- Excellent organizational skills with a proven ability to multi-task and work well under deadline pressure.
- Advanced knowledge of Microsoft Office applications.
- A bachelor’s degree or 3 years of relevant experience in compliance in healthcare.
- Knowledge of Operational Site Visit, preferable.
- Certification in healthcare compliance is preferred (CHC).
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.
- Responsible for the oversight of our organization’s grant auditing process.
- Support business owners by providing review and recommendations to Corrective Action Plans.
- Review reports and financial data and contribute to the policies, procedures, and training to ensure fiscal responsibility.
- Works closely with various departments including but not limited to HR, legal, finance, operations, and clinical teams to promote a culture of compliance.
- Monitor, review, and provide guidance on federal and state regulations impacting privacy relates initiatives.
- Conduct privacy compliance investigations.
- Contribute to the ongoing development and refinement of our privacy initiatives, actively participating in privacy projects and audits.
- Ensure compliance with grant and contract requirements.
- Assist in the planning, design, implementation, and support of financial systems, related policies, and processes needed to identify and manage the revenue and expenditures of the organization and its various components.
- Prepare and/or review information and reports for internal and external stakeholders.
- Become knowledgeable of grant guidelines and expectations and advise programs on implementation and ongoing efforts to ensure compliance.
- Analyze and evaluate contract and grant budgets for correct calculation of expenditure categories such as salaries, percent of effort, salary adjustment increases, fringe benefits, indirect costs, materials, and equipment.
- Conduct routine compliance reviews of grant programs.
- Conduct research, evaluate, and present options for the selection of contractors/subrecipients according to the federal procurement and internal processes.
- Contribute to continuously improving internal grant management systems.
- Ensure all regulatory and/or grant-related training requirements are met and documented.
- Monitors the performance of the Compliance Programs and related activities on a continuing basis, taking appropriate steps to improve its effectiveness.
- Maintains record of changes and archived copies for potential compliance and/or risk inquiries.
- Provide support for regulatory audits from the Health Resources Service Administration (HRSA), Federal Tort Claims Act (FTCA), Operational Site Visit (OSV) and any third-party audits.
- Conducts on-site spot audits and coordinates with the Quality team.
- Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
- Identifies potential areas of compliance vulnerability and develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
- Maintain strict confidentiality about individual health center findings and proprietary information.
- Assist with the Credentialing and Privileging process.
- Travel between sites will be required.
- Performs all and any additional duties as assigned.
St. John’s Community Health is an Equal Employment Opportunity Employer
