YCHC Compliance Officer

Yakutat Tlingit Tribe•Yakutat, AK

About The Position

The Compliance Officer has principal authority and responsibility for the development, implementation, oversight and evaluation of all aspects of Yakutat Community Health Center’s (YCHC) Compliance Program and works hand in hand with YTT’s Compliance Officer. The Compliance Officer is authorized to investigate all instances of suspected illegal or unethical conduct and may upon obtaining appropriate authorization, and consistent with Health Center budget constraints, seek the advice of qualified legal counsel and hire outside investigators and/or consultants. This position requires compliance with Health Center’s compliance standards, including its Standards of Conduct, Compliance Program, and policies and procedures. Such compliance will be an element considered as part of the position’s regular performance evaluation.

Requirements

Comprehensive knowledge of self-governing tribal, Federal and state laws and guidelines for the administration of federally funded grant projects.
Considerable knowledge of correct business practices, correspondence, and typing formats, including grammar, composition, spelling and punctuation.
Knowledge and in-depth understanding of health care delivery systems, principles and practices.
Knowledge of management principles and practices.
Knowledge of relevant federal, state and local laws, accrediting agency rules and regulations.
Knowledge of the functions and operations of YCHC.
Ability to understand, analyze, and interpret Federal and state laws and regulations, grantor guidelines, financial reports, and legal documents.
Ability to respond effectively to complex inquiries from grantors and regulatory agencies.
Ability to identify and resolve problems in a timely manner; gather and analyze information skillfully; develop alternative solutions; work well in group problem solving situations; and uses reason even when dealing with emotional topics.
Ability and willingness to work flexible hours to meet the organization’s needs/demands.
Ability to work with personal computers and utilize a variety of software applications, including database and office software systems.
Ability to communicate clearly and effectively, both orally and in writing, using tact and sensitivity.
Skill in exercising good judgment and creative problem solving.
Skill in negotiation and conflict resolution.
Skill in developing and making effective presentations.
Skill in project management, establishing priorities, planning, and organizing work.
Skill in interpersonal relations.
Skill in use of personal computers and a variety of job-related software applications.
Skill in oral and written communication.
Skill in problem solving, mediating and resolving disputes, and interpersonal relations.
Bachelor’s Degree in Business Administration, Health Administration, or another related field. Post-secondary education or experience which provides the expertise required to perform effectively the functions of the position may substitute for the degree on a year for year basis.
Three (3) years of progressively responsible relevant experience including at least two (2) years of supervisory/management experience.
Must successfully pass a criminal and background check.
Possession or ability to readily obtain a valid driver’s license clean driving record.

Nice To Haves

Experience working with IHS and Community Health Center agencies helpful but not required.
Experience in working with the Native American population preferred.

Responsibilities

Overseeing and monitoring the development and implementation of the Health Center’s Compliance Program through establishment of the annual work plan.
Works with Risk Manager to identify high risk areas through risk assessments and other means;
Identifying methods to reduce vulnerability to fraud and abuse, such as conducting periodic audits, developing effective lines of communication on compliance issues and preparing written practice standards and procedures;
Serves as lead and takes primary responsibility for the implementation of a new compliance management software program used to comply with federal healthcare laws and regulations. Tasks will include data entry of employees, vendors, contract agreements and policies and procedures.
Periodically revising the Compliance Program and its policies and procedures or recommending such revisions to the Policy and Procedure Committee and/or YTT Tribal Council, of changes in the needs of Health Center, changes in law and/or in standards and procedures of government and private payer health plans.
Suggesting policies related to compliance to the Tribal Council and developing procedures implementing policies approved by the Council.
Coordinates training programs that focus on the components of the Compliance Program and seeks to ensure that all individuals affiliated with YCHC, (i.e. Council members, employees, contractors, vendors, agents and volunteers) are knowledgeable of and comply with pertinent Federal and state standards and Health Center’s Compliance Program and Standards of Conduct.
Coordinate with Human Resources to ensure that the HHS OIG’s List of Excluded Individuals and Entities and the General Services Administration system for award management has been checked with respect to all individuals affiliated with YCHC.
Receiving reports or allegations of unethical, improper conduct or business practices and responding to such reports, by conducting investigations independently, in coordination with qualified legal counsel, or by delegating the responsibility for investigating other staff to a qualified third party and implementing and monitoring appropriate corrective action and subsequent compliance;
Coordinating with Human Resources to ensure the consistent and fair application of disciplinary action, when applicable; and
Reports information on the activities of the Compliance Program to the Health Director (HD) and Tribal Council on a quarterly basis.
Serves as the Health Insurance Portability and Accountability Act (HIPAA) Privacy Officer and is responsible for the oversight of Privacy Rule implementation by departments and has the ultimate responsibility for ensuring HIPAA Privacy Rule policies are implemented and followed.
Ensure that the necessary and appropriate HIPAA related policies are developed and implemented to safeguard the integrity, confidentiality and availability of Electronic Protected Health Information (EPHI) within the covered entity.
Ensure that the necessary infrastructure of personnel, procedures and systems is in place to: a) develop and implement the necessary HIPAA related policies; b) monitor, audit and review compliance with all HIPAA related policies; c) provide a mechanism for reporting incidents and HIPAA security violations; and d) act as a spokesperson and single point of contact for YCHC in all issues relating to HIPAA security.
Serves as the lead for the review and resolution of reported complaints and/or incidents; ensures complaints/incidents are properly documented in Compliatrics; follow-up with key stakeholders to ensure timely resolution.
Ensures compliance with all grants and tracks progress and identifies any deficiencies.
Works with YTT’s Compliance Officer ensuring the proper routing of all legally binding agreements for YCHC including MOAs, MOUs, Insurance Policies, Contract Agreements and Business Associate Agreements. Management tasks may include negotiating and editing agreements, collecting signed authorization forms for each agreement, monitoring the agreement, filing electronic copies, and tracking/logging all current and expired agreements.
Oversite for credentialing and privileging program; develops credentialing and privileging procedures; in accordance with YCHC’s Credentialing and Privileging Policy.
Must comply with federal laws and regulations as required by the HIPAA.
Performs related duties.