Director of Compliance & Privacy
Director of Compliance & Privacy
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1 Vacancy
Job Description
Central Ohio Primary Care is seeking a Director of Compliance & Privacy for our central business office in Westerville OH. The Director of Compliance & Privacy is responsible for providing leadership direction and oversight/management of COPCs Compliance Integrity and Risk Management Programs. The general duties and responsibilities include continually evaluating and improving these programs and managing monitoring and auditing COPCs Compliance Plan compliance hotline Code of Conduct all COPC policies and procedures privacy compliance and related activities to ensure compliance with Ohio and federal healthcare laws and regulations.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Implement and manage COPCs Annual Compliance Plan and related initiatives; recommend modifications as needed.
- Chair the Compliance Committee which oversees the implementation of COPCs Compliance Plan and all compliance-related activities.
- Prepare monthly compliance reports identifying compliance issues.
- Prepare a quarterly report to COPCs Board of Directors on compliance issues.
- Periodically report to COPCs Board of Directors Physician Advisory Committee Senior Leadership and Office Managers on compliance matters.
- Manage and perform E/M coding audits of providers.
- Manage and perform compliance site visits.
- Manage privacy policy perform HIPAA breach analysis and send breach notification letters.
- Serve as COPCs Privacy Officer.
- Advise and educate COPC leadership physicians and staff on issues concerning compliance matters including recommending policies and controls designed to ensure compliance and mitigation of risks regarding billing coding documentation and referral arrangements.
- Work collaboratively with leadership in risk management compliance development and implementation.
- Establish effective working relationships and build credibility with the physicians and staff to support a culture of compliance.
- Investigate respond to and work to resolve all compliance related complaints or concerns received on the Compliance Hotline.
- Maintain a log of all compliance complaints and their resolution.
- Prepare manage and update COPCs compliance education and training program to ensure that all physicians staff and contractors if applicable are knowledgeable of Ohio and federal healthcare laws and regulations.
- Coordinate with all COPC departments including the legal department to identify risks to COPC and develop auditing monitoring and oversight processes to mitigate or eliminate the risks.
- Oversee investigations and implementation of corrective actions and monitoring in response to identified issues and audits.
- Draft update and enforce COPC policies and procedures that encourage COPC employees leadership contractors and physicians to report suspected fraud or abuse or other improprieties without the fear of retaliation.
- Act as a consultative resource on compliance and risk management matters.
QUALIFICATIONS:
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
A. Experience Education Licensures & Certifications
- Required: Bachelors degree in related field of study.
- Preferred: Masters degree or a certification in healthcare compliance or risk management.
- Required: Minimum of 8 years of relevant experience required.
B. Knowledge Skills & Abilities
- Demonstrated knowledge and experience in compliance process improvement OIG workplan and the requirements of federal healthcare law and regulations including HIPAA Anti-Kickback Stark Coding medical records Medicare/Medicaid fraud waste & abuse and licensing issues.
- Experience in clinical legal auditing or other compliance settings preferred.
- Clear concise and persuasive writing and presentation skills.
- Strong organizational skills and ability to respond well under pressure.
- Proficient with information systems and databases as well as Microsoft Office products (including Excel Word PowerPoint and Teams).
- Well-developed communication presentation and consensus building skills.
- Ability to work well with all levels of employees and Physicians in the organization.
- Exceptional attention to detail.
- Proficiency in exercising a high degree of initiative judgment discretion and decision making to achieve organizational objectives.
- Capability to maintain a high level of integrity and confidentiality relating to physicians employees patients and the company
- Background collaborating regularly with executive teams and physician leadership.
- Aptitude to identify document resolve and/or escalate issues while identifying improvement opportunities for current processes.
Required Experience:
Director
Employment Type
Full-Time
