Unified Physician Management

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Compliance Specialist

at Unified Physician Management

Posted: 4/1/2019
Job Status: Full Time
Job Reference #: 635
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Job Description

Under the direct supervision of the Compliance Services Manager, the Compliance Specialist is responsible for the management of workflow analysis, productivity, quality review, problem resolution, and reporting. In addition, the Compliance Specialist ensures the Organization’s operational practices, comply with all local, state, federal, civil, criminal and administrative laws, rules and regulations including fraud and abuse laws. The ideal candidate will exude energy, curiosity, and enthusiasm, and bring with them prior compliance experience. Applications utilized are: Excel, Word, E-Mail, Outlook, PowerPoint and Visio.

Essential Job Functions:  

  • Implements continuous process improvement initiatives. Diagrams and evaluates existing processes.
  • Develops metrics that provide data for process measurement, identifying indicators for future improvement opportunities.
  • Collects data to identify root cause of compliance issues.
  • Measures performance against process requirements. Aligns improvement to performance shortfalls. Provides consultation on the use of re-engineering techniques to improve process performance and service quality.
  • Assist with ongoing maintenance of the overall Compliance Program
  • Conduct research in an effort to keep up to date with new compliance rules and applicable regulatory changes
  • Provide strategic recommendation support with regards to policies, rules and regulations.
  • Provides assistance with development of Policies and Procedures
  • Ensures policies and procedures are continuously monitored and evaluated.
  • Assist with the development of comprehensive training plans while overseeing periodic compliance training and education deemed necessary by the Compliance Services Manager.
  • Assist with new hire and annual compliance training
  • Assist with the innovation and continuous improvement of IT internal control framework, including the integration of multiple compliance requirements.
  • Participate in information security initiatives and projects.
  • Monitors and provides oversight of the Compliance Hotline
  • Monitors and provides oversight to the monthly exclusion database
  • Performs other job-related duties within the job scope as requested by the Director of Compliance.

Position Requirements:

  • Knowledgeable of HIPAA, Medicare, Medicaid, OSHA, Anti-Kickback, Stark and False Claims Act
  • Experience with and is knowledgeable of compliance specifically for OB/GYN practices preferred
  • Bachelor's degree in Business or Healthcare required, graduate degree a plus
  • Minimum of two years compliance experience within the healthcare industry
  • Experience in developing policies and procedures, streamlining operations
  • Experience with authoring compliance audit/investigation reports
  • Experience with conducting research and having the ability to articulate requirements at a high level
  • Must have experience extracting and connecting data from disparate sources and deliver high-quality, reliable results
  • Strong interpersonal, written and verbal communication skills, able to communicate technical concepts and plans at all levels
  • Exceptional attention to detail and excellent organizational and time management skills;
  • Ability to lead and execute multiple projects (short and long term) and tasks accurately and on time;
  • Candidate should be energetic, self-motivated, and a team-oriented individual who thrives on challenge in a fast-paced dynamic environment