Senior Compliance Analyst - FT - Days - Corporate Compliance @ MV

El Camino Health•Mountain View, CA

About The Position

El Camino Health is seeking a Senior Compliance Analyst for its Corporate Compliance team. The role monitors and analyzes federal and state healthcare requirements, communicates regulatory developments to affected departments, and supports organizational responses. It designs and conducts compliance audits and monitoring, investigates confidentially reported concerns and potential violations, documents findings, and recommends remedial actions. The analyst assists with compliance policies, procedures, and guidelines; develops and delivers staff and management training; participates in compliance risk assessments; and identifies emerging risks and mitigation strategies. The role prepares reports, dashboards, and trend analyses for the Compliance Committee and senior leadership, maintains records of compliance activities and corrective actions, and serves as a liaison to clinical, revenue cycle, legal, and other departments. It also reviews coding, billing, and documentation practices against government payer requirements and assists with responses to government inquiries, audits, and information requests.

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 with discretion 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), or be able to obtain the certification or 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 regulatory developments to affected departments and support the organizational response.
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 reported through the compliance hotline or other channels.
Document investigation findings and recommend appropriate remedial actions.
Assist in developing, reviewing, and updating compliance policies, procedures, and guidelines, ensuring alignment with current requirements and best practices.
Develop and deliver compliance education and training programs for staff and management.
Identify training needs based on investigations, audits and monitoring, regulatory and industry developments, and areas of elevated risk.
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 documentation of compliance activities, investigations, and corrective actions.
Serve as a compliance liaison to clinical, revenue cycle, legal, and other departments; provide guidance and support development of compliant workflows.
Review coding, billing, and documentation practices for compliance with Medicare, Medicaid, and other government payer requirements.
Assist in responding to government inquiries, audits, and requests for information.
Perform other duties as assigned.