CareSTL Health
  • 11-Oct-2018 to 10-Dec-2018 (CST)
  • Compliance
  • St. Louis, MO, USA
  • Salary
  • Full Time

Medical, Dental, Vision, 403B, STD/LTD, PTO


CareSTL Health seeks a Director of Compliance to designs and implements programs, policies, and practices to ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA), the Health Resources and Services Administration (HRSA), the Occupational Safety and Health Administration (OSHA), and the National Committee on Quality Assurance (NCQA) accreditation standards.

 

Duties:

  • Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct and assists with the day-to-day operation of the Program.
  • Compiles information by providing overviews of disclosures, breaches, and investigation results as requested by the Corporate Compliance Officer and keeps departments abreast of requirement guidelines.
  • Works with the Corporate Compliance Officer and the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees, managers and providers.
  • Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
  • Responds to alleged violations of rules, regulations, policies, procedures, and standard protocol by recommending the initiation of investigative procedures.
  • Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline or confidential voicemail for reporting; (b) heightened awareness of policies, procedures, and standards, and (c) understanding new and existing compliance issues and related policies and procedures.
  • Monitors the performance of the Compliance Program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness.
  • Researches regulations by reviewing regulatory bulletins and other sources of information (i.e. webinars).
  • Coordinates activities and acts as liaison with regulatory or review bodies
  • Reviews and recommends contracts, insurance companies, and managed care organizations
  • Develops cooperative relationships with other healthcare organizations and hospitals
  • Selects specific topics for review such as problem procedures, drugs, high volume cases, high risk cases, accounting protocols, and other factors

 

A Successful Candidate:

  • Excellent oral and verbal communication skills
  • Excellent organizational and self-motivational skills

 

Qualifications:

  • Education:  Bachelor's Degree in Health Administration, Business Administration, Human Services, or related field required. Master's Degree preferred. Paralegal preferred
  • Experience: A minimum of 3-5 years related experience required.
  • Other:  Must have reliable transportation.
CareSTL Health
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