Compliance & Privacy Officer

NorthCare Network•Marquette, MI

3d•$87,818 - $118,560•Hybrid

About The Position

NorthCare Network is a Specialty Prepaid Inpatient Health Plan (PIHP) located in Marquette, Michigan and is responsible for the management and service array available to residents of Michigan’s Upper Peninsula with behavioral health needs covered by Michigan Medicaid and specialty grants for substance use disorder services. RESPONSIBILITIES INCLUDE: Under the supervision of the Chief Executive Officer, the Compliance & Privacy Officer is responsible for developing and overseeing policies and procedures to ensure the organization’s compliance with legal and ethical standards. This position manages adherence to federal and state laws, regulatory guidelines, and Centers for Medicare and Medicaid Services requirements. This position will work closely with many departments and provider agencies to ensure that activities and operations adhere to internal policies and external regulations. The Compliance & Privacy Officer shall also oversee ongoing activities related to the development, implementation, and maintenance of the organization’s privacy policies in accordance with applicable federal and state laws including, but not limited to HIPAA, HITECH, and Omnibus requirements. The Compliance & Privacy Officer upholds established standards and assists in ensuring compliance across the Provider Network. This position is the designated FOIA Coordinator for NorthCare. This position will serve as the respondent for Medicaid Fair Hearings for the Region.

Requirements

Bachelor’s Degree in Business Administration, Healthcare or Public Administration, Clinical Services, or related field preferred.
Five years of experience in managed care or behavioral health service delivery working with regulatory, documentation, accreditation, auditing/monitoring, and/or billing systems is required.
Other education or experience that provides the required knowledge, skills, and abilities to perform the job may be considered.

Responsibilities

developing and overseeing policies and procedures to ensure the organization’s compliance with legal and ethical standards
managing adherence to federal and state laws, regulatory guidelines, and Centers for Medicare and Medicaid Services requirements
working closely with many departments and provider agencies to ensure that activities and operations adhere to internal policies and external regulations
overseeing ongoing activities related to the development, implementation, and maintenance of the organization’s privacy policies in accordance with applicable federal and state laws including, but not limited to HIPAA, HITECH, and Omnibus requirements
upholding established standards and assists in ensuring compliance across the Provider Network
designated FOIA Coordinator for NorthCare
serving as the respondent for Medicaid Fair Hearings for the Region