Compliance Officer

Tule River Indian Health Center Inc•Porterville, CA

1d•Onsite

About The Position

The Compliance Officer is responsible for planning, designing, implementing and maintaining TRIHCI-wide compliance and audit programs; establishing policies and procedures designed to promote a corporate culture that fosters ethical and compliant behavior and provides the basis for ensuring adequate internal controls and compliance with all laws, regulatory or contractual requirements applicable to TRIHCI, as well as TRIHCI’s internal policies. The Compliance Officer reports directly to Chief Executive Officer/Principal Investigator and to the TRIHCI Board of Directors regarding compliance issues. In addition, He/she is responsible for assessing, monitoring and mitigating risks to the TRIHCI; oversight of compliance audits, conducting compliance investigations; implementing compliance education and training for employees; and maintaining the organization’s compliance hotline. The Compliance Officer serves as a resource to TRIHCI staff and member health program staff on compliance related issues; upon request, may assist member programs with their compliance reviews. He/she serves as TRIHCI’s HIPAA Privacy Officer. The Compliance Officer is authorized to implement all necessary actions to ensure the achievement of the objectives as outlined in the Corporate Compliance Program.

Requirements

Must have knowledge of federal and state regulations related to health services, confidentiality, privacy regulations and fraud/abuse laws.
Must have in depth knowledge of Office for Civil Rights regulations pertaining to HIPAA Privacy.
Certified in Healthcare Compliance (CHC) through Health Care Compliance Association required.
Demonstrates skills in performing investigations, strong oral and written communication skills and high ethical standards.
Expertise in use of Microsoft Word, Excel and Power Point.
Ability to work well under pressure, work with multiple constituencies and communicate effectively is essential.
Must have previous supervisory experience.
Must have at least 3 years experience in leadership role in healthcare with a demonstrated understanding of all elements of an effective compliance program or Bachelor’s degree in healthcare field.
Must have at least 6 years experience in leadership role in healthcare with a demonstrated understanding of all elements of an effective compliance program.
Must have a Valid California Driver License and be insurable with the Tule River Indian Health Center Inc. insurance agency.

Nice To Haves

Certification in Healthcare Privacy and Security (CHPS) through the American Health Information Management Association (AHIMA) or Certification in Healthcare Privacy Compliance (CHPC) through the Health Care Compliance Association strongly preferred.
Master’s degree in healthcare field preferred.

Responsibilities

Oversees, coordinates, and monitors compliance program and activities. If any misconduct or non-compliance is detected, recommend solutions and follow up to ensure that recommendations have been implemented.
Develops and coordinates compliance training and education programs.
Ensures conformance with applicable laws, statutes, regulations, and internal policies and controls.
Coordinates resources to ensure the ongoing effectiveness of the Corporate Compliance Plan.
Assures development of TRIHCI’s Annual Compliance Work Plan.
Reports on a regular basis to the TRIHCI Board of Directors.
Independently investigates and acts on matters related to compliance, including the flexibility to design and coordinate internal investigations (e.g., responding to reports of problems or suspected violations) and any resulting corrective action.
Responsible for compliance investigations relating to all departments, providers, agents and, if appropriate, independent contractors.
Develops policies and programs that encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.
Acts as TRIHCI’s HIPAA Privacy Officer.
Serves as resource to TRIHCI on healthcare laws, regulations, internal auditing procedures and standards including HIPAA.
Monitors operation of the company’s anonymous compliance hotline, including processing and complaints and/or reported violations, and determining how to address each call in a timely manner, including review and investigation, as appropriate.
Assist TRIHCI departments with development of their compliance programs.
Regular and predictable attendance.
Other duties as assigned.
Participation in all required staff meetings.
Performing of duties or other related responsibilities as needed and assigned.