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Compliance Officer
Chase Brexton Health Services | |
90000.00 To 120000.00 (USD) Annually | |
United States, Maryland, Baltimore | |
May 01, 2024 | |
JOB SUMMARY: 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: 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, Risk Management, and Procedure * Develops initial and ongoing compliance training for the workforce * Serves as Compliance Officer * Serves as Privacy Officer * Serves as Risk Manager * 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) * Drafts new policies, ensuring compliance with laws and regulations * Reviews existing policies for regulatory and statutory compliance * 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 * Audits credentialing files intermittently for compliance and in anticipation of audits * Compiles monthly and quarterly risk management reports for committee use and board review 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 * Investigates staff and liaisons with HR pursuant to disciplinary measures * Interfaces with all departments to coordinate and resolve compliance issues * 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 in Nursing with current RN degree or Juris Doctor and barred in Maryland * Required: Minimum of 2 years relevant experience required; 5-7 years preferred * Preferred: Experience with FQHCs or Look-Alikes |