Senior Compliance Analyst - FT- Days - Corporate Compliance @ MV
About The Position
The Senior Data Analyst for Compliance and Privacy plays a vital role in supporting the organization commitment to maintaining adherence to state and federal laws for Stark compliance and safeguarding patient privacy. This position is responsible for monitoring and validating all payments made to physicians or referring providers to comply with Stark and Anti-Kickback regulations or to identify any potential violations or contract risks. This position is also responsible to monitor EPIC access to patient data to identify HIPAA or CDPH violations and ensure adherence to regulatory requirements to promote best practices across hospital and clinical operations. By leveraging privacy data analytics tools and collaborating with interdisciplinary teams, the analyst contributes to identifying potential privacy violations or risk while ensuring the integrity, security, and confidentiality of patient information. This role is integral to support both the organization Compliance and Privacy Programs and ensuring compliance with federal, state, and local regulations.
Requirements
- Bachelor’s degree in a related field (i.e., business, IT, health administration, health information management, data analytics, compliance)
- 2-5 years in a position having related responsibilities and duties
- Experience an understanding of Stark and HIPAA regulations, privacy program management, and compliance auditing in a clinical or hospital setting.
- Experience with privacy monitoring tools (e.g. FairWarning, Epic Hyperspace audit logs).
- Strong understanding of federal and state healthcare regulations, including Stark Anit-Kickback, HIPAA, CMIA, HITECH, and CMS guidelines.
- Excellent analytical and problem-solving skills, with the ability to interpret complex data sets and generate actionable insights with a strong attention to details.
- Exceptional organization and time management skills, with the ability to prioritize and manage multiple tasks effectively and attention to details.
- Proficient in data analysis tools (e.g. Microsoft Office, Excel, Tableau or similar)
- Ability to maintain strict confidentiality and handle sensitive information with discretion.
- Strong interpersonal skills and written communication skills to work effectively with multidisciplinary teams, including physicians, administrators, IT, medical staff, and legal departments.
Responsibilities
- Validate all payments to physicians or referring providers are compliant with contracts terms prior to AP reimbursement.
- Analyze all physician contracts for operational or reimbursement issues.
- Ensure time reports submitted by Medical Directors for administrative services are compliant with contract terms and hospital policy.
- Maintain detailed dashboards and reporting tools regarding all physician payments.
- Audit the annual physician expense report for the fiscal year provided by AP and compile a summary for the Board.
- Report any discrepancies identified to Manager and Legal.
- Conduct data analysis to identify trends, patterns, and anomalies related to Epic access by staff.
- Collaborate with clinical and administrative teams to audit and monitor compliance with internal policies and external regulations (e.g. HIPAA, CMIA, HITECH, CMS, Stark laws etc.).
- Analyze incidents of potential privacy breaches and support investigation to ensure proper documentation and privacy violation reporting.
- Collect, interpret, and analyze privacy-related data from various systems (e.g. EHR, billing systems, access logs).
- Ensure data quality, accuracy, and integrity in all compliance or privacy reports.
- Collaborate with legal, IT, and operations teams related to compliance and privacy matters.
- Leverage data analytics tools and systems (e.g. FairWarning, compliance software) to enhance monitoring and reporting capabilities.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
