Risk and Compliance Analyst II - Kern Admin

Clinica Sierra Vista•Bakersfield, CA

About The Position

The Risk and Compliance Analyst II is responsible for assisting in the development, implementation, and management of Clinica Sierra Vista’s (CSV) Compliance Program and Risk Management Plan. Ensures that all regulations are being followed and produces detailed reports to the supervisor based on Compliance and Risk Coordinator observations. Provides safety and privacy support for compliance initiatives and policies. Takes part in developing processes necessary for CSV and external agencies to remain compliant with any new regulatory requirements. The Compliance and Risk Coordinator will work closely with the Compliance and Risk Manager and other departments to create new protocols and improve consent forms, patients’ rights form, and other relevant documents as needed. The Compliance and Risk Coordinator will conduct audits at clinics and internally from a risk perspective. These audits will be used to mitigate any potential risks to patients or the organization.

Requirements

Master’s degree in Business or Public Administration, Public Policy, Health Care Planning or a related field required.
2 years of Compliance/Risk experience within the health care industry required; ambulatory care setting preferred.
Knowledge of compliance, quality improvement practices and audit techniques, or an equivalent combination of education and experience which would provide the required knowledge, the skills and abilities may be qualifying in lieu of.

Nice To Haves

Clinical experience as a Medical Assistant or Licensed Vocational Nurse preferred.
Certificate in Healthcare Compliance preferred.

Responsibilities

Conducts regular on-going review of Compliance Plan and Risk Management Plan in addition to all relevant state and federal statutes and regulations with duties including but not limited to: 1. Working with the Chief Medical Officer, Compliance and Risk Director, Compliance and Risk Manager, and Chief Administrative Officer to monitor changes in contractual provisions or regulations and communicate those changes to relevant staff within the organization.
Tracking regulatory updates from agencies such as The Joint Commission (TJC), HRSA, OSHA, FTCA, and revising annual compliance and risk employee trainings to ensure requirements are met.
Assisting the Compliance and Risk Manager in completing submissions to regulators.
Assisting the Compliance and Risk Manager in distributing open patient safety reports to respective departments.
Facilitates the proper handling of all claims/suits brought against the organization.
Participates in the proper handling of all patient complaints and incident reports supporting the Grievance Analyst.
Review policies and procedures to satisfy relevant state, federal, and/or industry standards and requirements and coordinate efforts with appropriate departmental staff to ensure implementation with duties including but not limited to: 1. Supporting consistency in policy content and format throughout the organization.
Coordinating efforts with appropriate departmental staff to verify that CSV practice matches plan policy; and,
Working with departments to revise policies and/or practices so that they are aligned and satisfy regulatory requirements.
Assists in the implementation of audit processes to ensure compliance with federal and state statutes and regulations and program guidance for the CSV Compliance Program.
Supporting the audit program, implementing, and conducting ongoing risk assessment processes at least quarterly.
Conducting audits, analyzing information, identifying deficiencies, developing reports and formulating recommendations for corrective action.
Conducting review of incident reports, analyzing information, identifying trends, develop reports and formulating recommendations for opportunities to mitigate risk.
Informing the Compliance and Risk Manager regarding situations of non-compliance.
Working with department directors and managers to implement corrective action plans, such as enhancement of employee trainings, review and improvement of processes in situations of non-compliance, monitoring progress and ensure completeness.
Monitoring compliance risks and ensuring that the departmental staff responds timely.
Responds to external requests for information, with duties including but not limited to: 1. Responding to audit requests.
Responding to subpoena requests.
Insurance requests such as proof of certificate of insurance.
Coordinating responses from appropriate department directors and managers.
Assisting in the preparation of Corrective Action Plans.
Assisting in the preparation of responses to additional information requests and patient comment letters, as needed.
Performs other duties as assigned.