Compliance Analyst - St. Luke's Health Plan

St. Luke's Health System•Boise, ID

12d

About The Position

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work. The Compliance Analyst assists in developing, implementing, and ongoing support of a proactive compliance program. This work includes conducting compliance-led audits and investigation activities, risk identification and mitigation efforts, and corrective action plan development and oversight. In addition, this position develops policies and procedures, supports regulatory agency responses, and provides staff guidance and education on compliance issues.

Requirements

Bachelor's Degree or experience in lieu of degree.
Three (3) years' relevant experience.

Responsibilities

Assists in the development and implementation of the annual risk-based compliance work plan.
Identifies ways to improve work processes and customer satisfaction.
Makes recommendations to leadership and implements and monitors results as appropriate in support of the overall goals of the Health Plan.
Leads assigned investigations of potential compliance incidents in collaboration with Compliance and Health Plan leadership.
nvestigation activities include conducting incident risk assessments, interviews, phone calls, meetings with involved parties, and detailed reporting of investigation activities.
Conducts internal and external audits, including development of audit tools, submission of audit notices, analyzing audit requests, developing audit work plans and assignments, completion of audits, ensuring compliance with Health Plan audit requirements, and developing audit findings reports with any necessary corrective action plan(s) and support(s).
Ensures compliance with corrective action plan and initiates further action(s) as necessary for failure to comply or meet timelines.
Prepares all documentation and supporting evidence according to audit quality standards in a consistent manner and in accordance with Health Plan policies and procedures.
Designs and delivers compliance training and orientation to employees, volunteers, medical and professional staff, and applicable business associates.
Develops and disseminates topic-specific education to Health Plan personnel based on identified risks or changes to policies and procedures or regulating authorities.
Coordinates the oversight of compliance programs of all First Tier, Downstream, and Related Entities (FDRs) and identified vendors to ensure compliance with state and federal regulations and effective compliance program elements to prevent, detect, and re-mediate noncompliance.
Develops and manages Health Plan policies and procedures.
Facilitates and provides subject matter expertise to recommend updates to best/evidence-based practices and implementation guidance.
Compiles information for compliance reporting, including reports for management and state/federal regulators. Depending on the complexity of the request, may perform analysis, identify trends, and follow up on opportunities for enhancement.
Contributes to the development of new and/or enhanced compliance programs and enterprise-wide initiatives.
Assists broadly in supporting overall compliance program initiatives as assigned by leadership.
Builds and maintains strong collaborative working relationships with key stakeholders on compliance issues, including the implementation of standards and requirements.
Maintains current knowledge of applicable federal and state laws to ensure ongoing compliance by the organization.
Performs other duties and responsibilities as assigned.