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Dir Privacy and Compliance Operations

Company: Lifespan Corporation
Location: Providence
Posted on: October 14, 2020

Job Description:

Summary:Under the general supervision of the Vice PresidentCorporate Compliance is directly responsible for the operations of variousportions of the Compliance Program and directly executes sections of theLifespan Compliance Plan. Directs the staff executing Lifespans Privacy Programwho monitor employee access to protected health information maintain HIPAAPrivacy log perform security breach analysis and make required reports tofederal agencies. Directs staffmaintaining enhancing and trending on results of the Compliance Programemployee reporting line (Response Line) and develops Compliance Programpolicies. Responsible for the executionof the annual conflict of interest survey process and responses to physicianand staff questions regarding conflicts and consulting opportunities. Directsand performs special investigations as requested and in compliance withLifespan policies and federal and state regulations. Facilitates and directs compliance andprivacy training to employee and physician staff. Directs the implementation ofcompliance operation enhancements such as management of the physician contractdatabase to ensure compliance with Stark and Anti-Kickback regulations.Prepares a written summary of work often under Attorney Client Privilegewhere problems are found and makes recommendations to correct.Responsibilities:ESSENTIAL FUNCTIONS:Responsible for directing and maintaining Lifespans PrivacyProgram by ensuring that sufficient procedural guidance and training has beendeveloped; relevant policies created employees are following these policiesand receiving required training etc.Provides Privacy training as required reviews and updates PrivacyTraining ensures employees are completing such training etc. Performs breach analysis and federallymandated reporting.Directs staff maintaining the Compliance Programconfidential employee reporting telephone line by responding to questionsregarding Compliance Policy or Regulatory interpretation or performingresulting follow-up investigations on substantive hot line complaints. Oversees the enhancement of the hot lineand subsequent reporting trending results on a monthly quarterly and annualbasis.Assists the Vice President Corporate Compliance andInternal Audit in the preparation meeting presentations and follow up actionsfor the Audit & Compliance Committee and the Executive Corporate ComplianceCommittee.Supervises staff to organize conduct privacy investigationsand audits to ensure compliance with Lifespan policies and federal and staterules. In consultation with the Vice President Corporate Compliance andInternal Audit Office of General Counsel; and often Lifespan SeniorManagement develops investigatory work steps or audit program guidelines andobjectives.Oversees the audit working papers such as compliancequestionnaires so that sufficient competent and evidential matter is obtained.Where applicable maintains workpapers to protect Attorney Client Privilege.Prepares written reports with and for the Vice PresidentCorporate Compliance of factual findings and recommendations. (Level and quality of report andrecommendations would normally require minimal revision).Cooperates with regulatory third party external auditorsand consultants. Review results of testchecks and other findings to identify further examination. Collaborate as needed to discuss findings ofspecial problems.Routinely acquires information on changes to variousthird-party standards including Medicare and Medicaid participating indevelopment of internal procedures to respond to same. Assess operational compliance to proceduresin various affiliate departments or units to maximize accuracy and completenessof charges and codes submitted for payment and to minimize other risks.Actively participates in the annual Compliance RiskAssessment by providing feedback and suggestions for potential areas of risk toreview. Audit and monitor.Directs review of the physician contract database to ensurecompliance with federal regulations such as Stark and Anti-Kickback.Acts as the Affiliate Privacy Officer for Lifespan CorporateServices and participates in all such privacy activities including a monthlyprivacy log for review.Coordinates and oversees the collection of the monthlyreview of the privacy logs from the Affiliate Privacy Officers at eachaffiliate.Facilitates and chairs the quarterly Affiliate PrivacyOfficer meeting including agenda preparation follow up and associatededucation.Responsible for scheduling and monitoring work assignmentsand re-prioritizing as necessary to maximize productivity. Orients new staff provide ongoing review ofwork to ensure accuracy and consistency of methodologies and serve as a functionalresource.Responsible for assisting in the implementation ofcompliance operations enhancements such as the implementation of the electroniccompliance software modules when needed.Executes various portions of the Lifespan Compliance Plandesigned to measure the risk of non-compliance demonstrate the effectivenessof the Program or enhance the level of system-wide compliance.Assists the Vice President Corporate Compliance and InternalAudit and Office of General Counsel by performing investigations arising fromcomplaints received via the hot line or because of federal or stateinvestigations.Collaborates to develop and provide compliance education toLifespan employees on general or specific issues when needed.Performs other related duties as required.Other information:BASIC KNOWLEDGE:A Bachelors Degree in Science or in a health scienceprofession is required. Masters degree preferred.Preferred certification in healthcare privacy required byHealth Care Compliance Association (CHPC).Preferred certification in healthcare compliance sponsoredby the Health Care Compliance Association (CHC)General knowledge of third-party reimbursement policiessufficient to compare details of diagnosis prescription treatment andevaluation to documentation necessary to obtain appropriate reimbursement forpatient care services.Full knowledge of HIPAA Privacy Act HIPAA Security Act andHHS Office of Inspector General Compliance Guidance.Knowledge of personal computer software applications thatinterface with various billing and training databases.Knowledge of spreadsheet and word processing applications.EXPERIENCE:Minimum of five years of Corporate Compliance/Privacy/HealthInformation Services experience or at a minimum of seven years of auditingexperience preferably in a similarly complex health care environment orexperience equivalent to seven years of accounting or financial managementexperience at a supervisory level to demonstrate broad-based knowledge ofhealth care operations and federal and state laws.Demonstrated strong written and oral communication skillssupervisory and problem-solving skills and project management skills andpersonal computer application skills.INDEPENDENT ACTION:Perform independently within Lifespans administrativepolicies and procedures referring unusual problems to the Vice PresidentCorporate Compliance and Internal AuditSUPERVISORY RESPONSIBILITY:Functional supervision for four full-time employees. Supervision consists of assigning workscheduling providing guidance and counsel and completing and renderingperformance evaluations.Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.Location: Corporate Headquarters USA:RI:ProvidenceWork Type: Full TimeShift: Shift 1Union: Non-Union

Keywords: Lifespan Corporation, Providence , Dir Privacy and Compliance Operations, Other , Providence, Rhode Island

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