Compliance Officer

JOB SUMMARY:



The Compliance Officer is responsible for determining all functions impacted by external governing organizations and ensures compliance. Serves as Compliance Officer and Privacy Officer and manages legal risk as described.



MAJOR DUTIES AND RESPONSIBILITIES:

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Analytical and Critical Thinking

Identifies potential areas of compliance vulnerability

Investigates claims of non-compliance submitted through Employee Hotline or other means

Manages all required breach determination and notification processes under HIPAA

Manages malpractice risk through involvement in the credentialing and privileging process

Identifies legal high risk areas through risk assessments and other means

Reviews subpoenas and coordinates with local law enforcement as needed



Compliance, Policy, and Procedure

Develops initial and ongoing compliance training for the workforce

Serves as Compliance Officer

Serves as Privacy Officer

Oversees compliance with new and existing federal, state, and local regulations (including compliance requirements for HRSA’s 330 grant, the 340B discount pharmacy program, and the FTCA).

Develops and maintains the organization Compliance Plan, compliance policies and procedures, and related forms

Develops and implements privacy and confidentiality policies and procedures and related forms

Develops and initial and ongoing privacy training to the workforce



Checking, Examining, and Recording

Collects, organizes, and reports on audit reports



Planning and Organizing

Coordinates site visits and compliance reviews by State and Federal regulators



Communication

Provides monthly reports to the Quality Excellence Committee

Cooperates with regulators and entities in compliance reviews or investigations

Collaborates with the IT Security Officer to ensure alignment between security and privacy compliance programs including policies, practices, and investigations

Collaborates with the IT Security Officer to establish an ongoing process to track, investigate and report inappropriate access and disclosure of protected health information

Cooperates with the U.S. Department of Health and Human Service's Office for Civil Rights, State regulators and/or other legal entities in any privacy compliance reviews or investigations

Works with the relevant departments in overseeing patient rights to inspect, amend, and restrict access to protected health information when appropriate

Consults with Finance and the insurance broker regarding wraparound coverage

Answers legal and risk management inquiries from providers

Responds to licensing boards, Joint Commission, or other entities conducting investigations

Coordinates with assigned counsel in the event of any malpractice claims

Provides liaison to outside counsel on other legal matters that cannot be handled in house



SKILLS AND ABILITIES:

Ability to synthesize and evaluate issues and recommend solutions as appropriate

Ability to analyze and solve problems

Ability to multi-task, prioritize, and work under deadlines

Ability to work collaboratively with national, state, or local auditors

Ability to communicate and negotiate with people at all levels

Ability to work effectively with a variety of people in a team environment

Ability to adapt to changes/challenges in organizational strategy, priorities, and directions, and the ability to overcome resistance to change

Ability to communicate clearly and effectively



EDUCATION AND/OR EXPERIENCE:

Required: BS/BA degree required.

Preferred: Masters in a healthcare-related field or Juris Doctor

Required: Minimum of 2 years relevant experience required; 5-7 years preferred

Preferred: Experience with FQHCs or Look-Alikes


PandoLogic. Keywords: Compliance Manager, Location: BALTIMORE, MD - 21201