Senior Compliance Analyst

Mom's Meals•Ankeny, IA

9d•Remote

About The Position

The Senior Compliance Analyst is responsible for supporting and overseeing the day-to-day operations and execution of the compliance and privacy programs within Momâs Meals. Duties include managing formal client/payor grievances, critical incident investigation and reporting, policies and procedures, and privacy incident response and remediation, and supporting payor/agency audit response. Successful candidates contribute to a positive culture of compliance at Momâs Meals. This position can be remote with occasional visits (possibly quarterly) to our headquarters in Ankeny, IA.

Requirements

Bachelorâs degree OR 8 years relevant experience
4-7 yearsâ experience in auditing, payer relations, compliance, privacy, information security or other relevant healthcare industry experience
Strong problem-solving skills including attention to detail
Ability to prioritize (and re-prioritize) projects in a fast-paced work environment
Effective written and verbal communication skills
Ability to work collaboratively to foster trust, credibility, and understanding
Ability to promote teamwork within department and organization
Exceptional personal organizational skills to meet deadlines, complete work assignments and projects and/or accomplish time sensitive work prior to due dates
Maintain working knowledge and understanding of various state/federal compliance and privacy laws, rules and regulations related to Medicare/Medicare Advantage plans, Medicaid, Managed Care Organizations
Proficient in Microsoft Office Applications including Word, Excel, PowerPoint, and Outlook

Nice To Haves

Certification in compliance, privacy or other relevant area

Responsibilities

Regularly review State and Federal laws, rules, in partnership with legal and notify internal business partners of applicable changes to ensure organizational compliance is maintained
Complete a regular review of policies and procedures to maintain alignment with state and federal compliance regulations; recommend updates, work with leadership to complete
Ensure resolution of Critical Incidents with appropriate internal business partners and notify agency caseworkers/contacts according to contractual and regulatory obligations
Investigate and ensure resolution to Grievances received from clients, agencies, and third parties; provide any required follow-up education to employees or leaders; collaborate with leadership to determine and implement corrective actions
Compile compliance metrics and analyzes results for ongoing tracking and Board and Executive review
Manage general compliance email as needed
Execute regular Compliance Program Self-Assessments based on the Department of Justice recommendations; propose internal action plans to strengthen Compliance posture within organization
Provide employee compliance education including onboarding, annual training, both departmental-specific and role-based training; participates in annual education review and as rules and regulations change; develops Compliance Tips for general education
Assist in development of compliance audit program by planning and conducting second line of defense compliance audits; communicate results to applicable internal business
Review and investigate impermissible use/disclosure reports; provides employee re-education
Participate in breach notification process
Develop and provide employee privacy education including onboarding, annual training, both departmental-specific and role-based training; participate in annual review education review or as rules and regulations change; Privacy Tips for general education
Assist in development and oversee HIPAA Auditing/Monitoring Plan and annual revision; privacy aspects of HITRUST; monitoring of program using OCR Audit Protocol
Act as an internal compliance/privacy resource for Momâs Meals employees
Engage in ongoing education and professional development to increase compliance expertise, business acumen, and regulatory knowledge
Collaborate with teammates, leadership team, and internal business partners to produce effective compliance and privacy program outcomes
Manage all external audit activity, including: audit intake, analysis, information/document requests from internal business partners, review and preparation, submission, auditor meetings, results review and response
Draft Corrective Action Plans (CAP) and Audit Appeals with input from applicable internal business leaders and Compliance Leadership in response to audit findings
Identify, track, and trend in auditing to ensure proactive preparation for future audits and/or determinations resulting in CAPs
Maintain electronic audit resource library to ensure up-to-date documentation
Maintain external audit tracking database to house all audit activity and status and supports reporting and data analytics of audit data