Compliance Specialist- Corporate (San Ysidro)

San Ysidro Health•San Diego, CA

15d

About The Position

Position Summary: Reporting directly to the Compliance Manager, the Compliance Specialist shall assist with the facilitation, implementation, and ongoing operation of the Corporate Compliance Department. Essential Functions of the Job: The Compliance Specialist will assist the Compliance Manager to administer San Ysidro Health’s (SYH) Compliance Program by assisting with the preparation and planning of the identified compliance-related committees and workgroups within the organization, including but not limited to 340B and the Corporate Compliance Program. Working knowledge of all applicable laws, regulations and standards relating to fraud, waste, and abuse; privacy; and security – including those enforced by the federal Department of Health and Human Services (HHS) and its agencies (including the Centers for Medicare and Medicaid Services [CMS], the Office of the Inspector General [OIG], and the Office for Civil Rights [OCR]) and State of California regulators such as the Department of Public Health (CDPH). Help oversee the Corporate Compliance Hotline log and reports. Assist the PACE Compliance Program on an as-needed basis to ensure compliance with applicable laws, regulations and standards. Assist the Compliance Manager with compliance monitoring, incident response and reporting, and workforce training; and help ensure SYH managers carry out their respective roles and responsibilities regarding these functions. Working knowledge of federal and state reimbursement program requirements (e.g., Medicare and Medi-Cal), Health Resources and Services Administration (HRSA), Health Center Program Compliance, federal and state Anti-Kickback Statutes and physician self-referral laws (e.g., Stark and PORA), as well as HIPAA and other applicable patient privacy rights and data protection laws. Assist the SYH management team with ongoing regulatory compliance audit preparation, including for health center and other periodic site visits. Requires excellent verbal, written and presentation skills, including the ability to facilitate meetings, and translate complex legal and regulatory requirements/issues into terms readily understandable by management, line personnel, and clinical personnel. Use of Windows PC and common software, including word-processing, email, and internet-based legal and regulatory websites. Ability to respond to questions and complaints with logic, clarity, calmness and authority, leading to desired support of actions by others. Well-developed skills in meeting timeliness and attention to detail. Serves as a project manager/coordinator for deliverables related to the Compliance program. Additional Duties and Responsibilities: Recognize the key issues related to applicable laws and regulations, such as patient and employee privacy and consumer protection, HIPAA, medical records, and HRSA requirements. Assist the Compliance Manager and other members of the Compliance team, develop and support an ethical culture at SYH, including increasing awareness of compliance issues among management and employees and encouraging a culture where employees can raise concerns without fear of retaliation. Ability to manage multiple concurrent projects with strict and competing deadlines. Assist management in the ongoing compliance monitoring of all business associate agreements to ensure that all privacy concerns, requirements and responsibilities are addressed. Assist with the identification and maintenance of the organization’s policies and procedures in coordination with the Compliance Manager and SYH’s Compliance Committee. Performs other duties as assigned.

Requirements

(2) years performing duties within a corporate health care compliance, privacy, information security, quality assurance, and or risk management department.
(2) years conducting HIPAA and False Claims Act training, in person and utilizing Microsoft PowerPoint presentations.
(2) years auditing regulatory compliance and performing data protection, e.g. to help identify and prevent fraud, waste, and abuse; as well as unauthorized access, use, and disclosure of protected health information (PHI).
BA Degree or equivalent relevant experience.
Ability to communicate effectively in writing and conversations with team members, other SYH stakeholders, patients, regulators, and other outside parties.
Ability to take accurate meeting minutes and investigation interview notes.
Exceptionally strong critical thinking and problem-solving skills.
Experience using Compliatric or a similar compliance and privacy incident case management system.
Experience using FairWarning or a similar privacy and security system information and event monitoring (SIEM) application.
Ability to use Epic EMR care delivery, HIM, and/or reporting modules.
Strong Microsoft Excel skills.
Knowledge of Software Programs: Epic EMR, Compliatric, FairWarning, Microsoft Office, and Easy Generator.
Standing, walking, minimal lifting and noisy environment.
Flexibility in schedule to meet project deadlines.
Sitting for extended periods of time.
Sufficient dexterity to effectively operate a computer keyboard and other related peripherals.
May be required to work evenings and/or weekends and attend meetings outside of regular working hours.
Travel may be required.
Pre-employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre-employment PPDs.
Compliance with all mandated vaccinations and all boosters is a term and condition of employment.

Nice To Haves

(4) years of health care compliance, privacy or other corporate regulatory oversight; regulatory training; and audit and monitoring/tracking job responsibilities.
Understanding of the San Diego PACE Program compliance requirements.
Experience in an FQHC environment.
Working knowledge of the Health Resources and Services Administration (HRSA) 340B Drug Pricing Program.
Project management expertise.
Certification in Healthcare Compliance (CHC).
Certified Professional Compliance Officer (CPCO), Certified Healthcare Compliance Officer (CHCO), Certified in Healthcare Privacy and Security (CHPS), and/or Certified in Healthcare Privacy Compliance (CHPC).
Bilingual preferred, ability to read, write, and speak Spanish.

Responsibilities

Assist with the facilitation, implementation, and ongoing operation of the Corporate Compliance Department.
Assist the Compliance Manager to administer San Ysidro Health’s (SYH) Compliance Program
Assist with the preparation and planning of the identified compliance-related committees and workgroups within the organization, including but not limited to 340B and the Corporate Compliance Program.
Help oversee the Corporate Compliance Hotline log and reports.
Assist the PACE Compliance Program on an as-needed basis to ensure compliance with applicable laws, regulations and standards.
Assist the Compliance Manager with compliance monitoring, incident response and reporting, and workforce training; and help ensure SYH managers carry out their respective roles and responsibilities regarding these functions.
Assist the SYH management team with ongoing regulatory compliance audit preparation, including for health center and other periodic site visits.
Serves as a project manager/coordinator for deliverables related to the Compliance program.
Assist the Compliance Manager and other members of the Compliance team, develop and support an ethical culture at SYH, including increasing awareness of compliance issues among management and employees and encouraging a culture where employees can raise concerns without fear of retaliation.
Assist management in the ongoing compliance monitoring of all business associate agreements to ensure that all privacy concerns, requirements and responsibilities are addressed.
Assist with the identification and maintenance of the organization’s policies and procedures in coordination with the Compliance Manager and SYH’s Compliance Committee.
Performs other duties as assigned.