Senior Compliance Analyst - FT - Days - Corporate Compliance @ MV
About The Position
El Camino Health is hiring a Senior Compliance Analyst for its Corporate Compliance team. The role monitors healthcare laws, regulations, and standards and communicates relevant developments to departments while supporting the organization’s response. It conducts compliance audits, monitoring, and confidential investigations; helps maintain compliance policies and training; participates in risk assessments; and reports compliance activity and trends to committees and senior leadership. The analyst also advises departments on compliance questions and reviews coding, billing, and documentation practices for government payer requirements.
Requirements
- Bachelor’s degree in healthcare administration, business, law, nursing, or a related field.
- Minimum 3–5 years of progressive healthcare compliance experience.
- Strong working knowledge of applicable legal and regulatory requirements, including HIPAA and OIG Compliance Program Guidance.
- Excellent analytical, critical-thinking, and problem-solving abilities.
- Strong written and verbal communication skills, including the ability to present complex information to varied audiences.
- Ability to work discreetly and maintain strict confidentiality.
- Ability to manage multiple priorities and work effectively independently and as part of a team.
- High degree of personal integrity and professional ethics.
- Must hold Certified in Health Care Compliance (CHC) certification or be able to obtain the certification or an equivalent within 24 months of hire.
Nice To Haves
- Graduate degree (JD, MHA, MBA, or equivalent).
- Experience with compliance auditing, monitoring, and investigation processes.
- Experience with healthcare billing, coding, and documentation requirements.
Responsibilities
- Monitor and analyze federal and state healthcare requirements, including HIPAA, the Anti-Kickback Statute, the False Claims Act, CMS Conditions of Participation, and The Joint Commission standards; communicate developments to affected departments and support organizational responses.
- Design and conduct compliance audits and monitoring activities to assess adherence to requirements and organizational policies.
- Conduct confidential investigations of compliance concerns, complaints, and potential violations; document findings and recommend remedial actions.
- Assist in developing, reviewing, and updating compliance policies, procedures, and guidelines.
- Develop and deliver compliance education and training for staff and management, identifying training needs based on investigations, audits, monitoring, regulatory and industry developments, and elevated-risk areas.
- Participate in annual and ongoing compliance risk assessments; identify emerging risks, evaluate controls, and recommend mitigation strategies to leadership.
- Prepare compliance reports, dashboards, and trend analyses for the Compliance Committee and senior leadership; maintain accurate records of compliance activities, investigations, and corrective actions.
- Serve as a compliance liaison to clinical, revenue cycle, legal, and other departments; provide guidance and support the development of compliant workflows.
- Review coding, billing, and documentation practices for compliance with Medicare, Medicaid, and other government payer requirements.
- Assist with responses to government inquiries, audits, and requests for information.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
